When crippling back pain forced Robin Henderson to leave her job last year, Medicaid was a godsend.
"If I didn't have the coverage, I would be in trouble. I would be in pain, without money, and health," said Henderson, who worked as a bus driver in Indianapolis before pain forced her to quit.
She gained coverage through the Healthy Indiana Plan — nicknamed HIP 2.0 — the state's version of Obamacare's Medicaid Expansion. Indiana got a waiver from the Obama administration to launch the program in 2015.
The key architect behind HIP was consultant Seema Verma, the president and founder of Indianapolis, Indiana-based health policy consulting firm SVC. She was hired by then-Governor Mike Pence, and after helping launch the Indian program would go on to help design Medicaid expansion plans in several states headed by Republican governors who had opposed the Affordable Care Act, including Ohio and Iowa.
Now, Verma has been nominated by President Donald Trump to head the Centers for Medicare and Medicaid, or CMS, where she will be deeply involved in implementing the Trump administration's plans to repeal and replace the ACA.
"I've never seen somebody in the job… come to this with really only Medicaid experience," said Joan Alker, the executive director of Georgetown University's Center for Children and Families and research professor at the McCourt School of Public Policy.
"I think that speaks to how important the Medicaid system has become in our health-care system," Alker said.
Back home in Indianapolis, Verma gets high marks for working across the aisle to help secure buy in to the plan from state legislators, the Obama administration, and local health-care leaders.
"You find her to be a collaborator," said Jonathan Nalli, senior vice president at Ascension Health, the state's largest health system. "She is somebody that every time you encounter her, it is 'what is our ability to solve the problem?' and 'how do we obtain that solution?'"