INDIANAPOLIS (AP) — The architect of Indiana Gov. Mike Pence‘s expansion of Medicaid may now play a key role in implementing any plan that might replace President Barack Obama’s signature health care law.

Seema Verma was named as President-elect Donald Trump’s choice to head the Centers for Medicare and Medicaid Services. The position could give Verma a significant voice if Trump acts on his promise to repeal and replace the Affordable Care Act.

Verma designed Pence’s expansion of Medicaid under the federal health care law, but with a conservative twist: It requires poor people to pay nominal fees for medical care. In most states, the poor are not required to pay such fees.

Trump says Verma will help “transform our health care system for the benefit of all Americans.”