WASHINGTON – The head of Medicare and Medicaid called Sen. Bernie Sanders’ Medicare for All proposal “absolutely lousy” Tuesday and said instead that Medicaid recipients need incentives to work their way out of poverty.

Seema Verma defended the Trump administration’s health care policies at a panel discussion hosted by the Atlantic Council and United Healthcare.

“The administration is often accused of sabotage,” said Verma. “We are making changes for the greater good.”

Verma insisted that no one wants to receive federal assistance and those on Medicaid, the federal health care program for the poor and disabled, need “incentives” to find work. She said the administration should focus on “giving people a pathway out of poverty.”

Verma also said Medicare for All would shift the focus of the plan from seniors and is an “absolutely lousy idea,”, saying studies have shown it would cost the federal government $32 trillion.

But Georges Benjamin, executive director of the American Public Health Association, disagreed with Verma.

“We need to have a system where everyone is in and no one is out,” said Benjamin.

Verma also defended Arkansas’ Medicaid work requirement program, which caused 4,000 people in the state to lose coverage, claiming that it helped lift people out of poverty by giving them “the skills they need and matching them with the jobs that are available.”

Though Arkansas is the first state to institute such a program, three other states have applied for federal waivers to do so.

Verma said the United States has a “great health care system,” but the level of health care spending is “simply unsustainable” and blamed excessive regulation.