Capitol Correspondence - 05.28.19

The “Indiana Mafia”: Politico Explores Vice President Pence’s Influence on Medicaid Policies

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ANCOR is sharing this article by Politico because it is important for our members to understand the key players on policies that affect people with disabilities. Medicaid is the main program funding supports for people with disabilities.

As written by Politico:

“[…] But behind the scenes, Pence has developed his own sphere of influence in an agency lower on Trump’s radar: Health and Human Services. It’s also the agency with the ability to fulfill the policy goal most closely associated with Pence over his nearly 20-year career in electoral politics: de-funding Planned Parenthood.

Numerous top leaders of the department — including Secretary Alex Azar, Surgeon General Jerome Adams and Medicaid/Medicare chief Seema Verma — have ties to Pence and Indiana. Other senior officials include Pence’s former legislative director from his days as governor and former domestic policy adviser at the White House.


Azar, who succeeded ousted HHS Secretary Tom Price in January 2018, was a top executive at Indiana-based drug company Eli Lilly when Pence was governor; Verma was his Indiana health adviser, and is now championing Medicaid reforms around the country that he embraced in Indiana; Verma’s deputy chief of staff, Brady Brookes, is Pence’s former Indiana legislative director; Adams, the surgeon general, is a former Indiana public health official. Rebekah Armstrong, who oversaw domestic policy in the vice president’s office at the start of the Trump administration, is also now stationed at HHS’ legislative affairs office.


At the outset of the Trump administration, Pence was involved in identifying like-minded nominees ‘particularly in roles Trump didn’t really care about,’ as one GOP operative put it.

Other allies say his state’s efforts to reduce regulation and federal oversight of health programs, defend religious conservatives who refuse to carry out policies antithetical to their opposition to LGBTQ rights or abortion rights, and impose coverage restrictions for recipients of federal aid are models for Trump administration initiatives.

Pence was ‘perhaps the key leader, or one of them’ in the GOP effort to scrap Obamacare, said Americans for Prosperity President Tim Phillips, a Koch-funded group that pushes free-market policies but doesn’t get involved in social issues. But beyond any particular policy, Phillips said, Pence is ‘an invaluable source of intelligence gathering for the administration for where key constituency groups and key Senate and House groups stand.’

‘I think that’s probably the most important role he plays,’ he added.


While Pence’s influence reverberates through HHS via the ‘Indiana mafia,’ individuals in and outside HHS emphasize that Trump, too, exerts significant influence over certain parts of the administration’s health care agenda, such as the push to lower prescription drug prices.”