Marilyn Tavenner Confirmed to Head Medicare,
Medicaid After Six Years of Senate Inaction
Jennifer Haberkorn of Politico Pro discusses the
confirmation and the future for the CMS chief in interview with Kaiser
May 16, 2013 – It only took about six and a half
years but the Senate has confirmed a chief administrator for the Centers
for Medicare and Medicaid Services. Marilyn B. Tavenner, the Obama
nominee, got the Senate nod yesterday on a 91-to-7 vote. She has been
acting head for two years after serving as Virginia’s health secretary
and as a hospital executive.
Mary Agnes Carey of Kaiser Health News interviewed
Jennifer Haberkorn of Politico Pro about the Senate's confirmation of
Tavenner and the challenges she will face. Below is the text of the
interview and a link to an audio version.
MARY AGNES CAREY: Welcome to Health on the
Hill, I’m Mary Agnes Carey. Today the Senate confirmed Marilyn Tavenner
to lead the agency that oversees Medicare and Medicaid. Tavenner now
becomes the first confirmed head of the Centers for Medicare & Medicaid
Services since 2006. With us to discuss this development is Jennifer
Haberkorn of Politico Pro. Thanks Jennifer for being with us.
JENNIFER HABERKORN, POLITICO PRO: Thanks for
having me, Mary Agnes.
MARY AGNES CAREY: Marilyn Tavenner had a
much easier time than her predecessor, Don Berwick, who was President
Obama’s first nominee to head CMS. Why?
JENNIFER HABERKORN: You’re right. It was
really like night and day. Don Berwick ran into a ton of opposition once
it became public that he made comments in support of the British health
care system. Marilyn Tavenner, on the other hand, did not have a history
of controversial statements. If there are skeletons in her closet, no
one has really found them yet. She had a relationship with the Hill; she
was at CMS for several years before her confirmation hearing at Senate
Finance [Committee], which went swimmingly.
There was also a significant amount of time between
the health law’s passage when politics, particularly over health care,
was at its peak on Capitol Hill. Don Berwick on the other hand, came up
shortly after the health law passed, when emotions were very raw. So, it
really was night and day – totally different situations.
MARY AGNES CAREY: While many Republicans
supported Marilyn Tavenner’s nomination today on the Senate floor and
House Majority Leader Eric Cantor also supported her, before the Senate
could vote on Marilyn Tavenner’s nomination, she had to overcome
objections of a key Democrat. Can you tell us about that?
JENNIFER HABERKORN: That’s right. Tom
Harkin, one of the health law’s greatest supporters on Capitol Hill
objected because the Obama administration keeps taking money out of the
Prevention and Public Health fund, which is kind of his baby in the
health care reform law. And he put a hold on Tavenner’s nomination,
meaning it couldn’t come up for a vote on the Senate floor for about a
He made it clear that he supported Tavenner’s
nomination, but wanted to do this to make a point. And senators have
done before on other nominations. He wanted to make a point that the
Prevention and Public Health Fund should not be touched anymore.
MARY AGNES CAREY: Why hasn’t CMS had a
confirmed administrator since 2006? What’s been the hold up there?
JENNIFER HABERKORN: It's mostly been
politics. There was a Republican nominee who came up at the end of the
Bush administration. It looked like he was about to get confirmed and
then at the last minute a Medicare regulation came out that angered some
Senate Democrats and they effectively stopped his nomination.
There was Don Berwick, who we talked about, was
nominated by President Obama and ran in to Republican opposition. Health
care is an easy target, politically. The Centers for Medicare & Medicaid
Services has one of the largest budgets in the federal government and
has a lot of authority. With that there is a lot of things to criticize.
So those nominees have gotten hung up. And there's also been moments
when presidents have decided not to nominate anyone at all. When
President Obama was first elected, it took him several, several months
before he put up a nominee.
MARY AGNES CAREY: What difference do you
think Marilyn Tavenner's confirmation will make in the implementation of
the health care law?
JENNIFER HABERKORN: I don't think it will
make a significant difference, particularly because she has been in this
job in acting capacity for about a year and half already. But at the
same time, these Republican senators, particularly the ones who voted
for her, can now call her up and say "Where are you on such and such
provision?" and "I have problems with the health law on this aspect,
what are you going to do about it?"
And just having her in that confirmed role makes it
a more even-handed conversation. She's been confirmed. She's gotten that
senator's vote and they need to have a conversation. But in the grand
scheme of things, it won't change too much.
MARY AGNES CAREY: Speaking of the health
care law, Department of Health and Human Services Secretary Kathleen
Sebelius has caused some concern on Capitol Hill about her efforts to
raise money to implement the law. What's the latest there?
JENNIFER HABERKORN: Right now a lot of
Republican senators are paying a lot of attention to the issue and
expressing concerns that it could be illegal for her to go to companies
that she regulates. HHS has said it has contacted providers and
religious groups to promote the health care law and that it is legal
under the Public Health Service Act to encourage programs that promote
public health. I think we are going to see continued attention on the
issue. It's not going to go away. Right now a lot of the oxygen on
Capitol Hill is taken up by Benghazi and the IRS. But definitely they
are going to come back to this and we might see Secretary Sebelius have
to answer questions publicly about what happened.
MARY AGNES CAREY: Thanks so much Jennifer
Haberkorn of Politico Pro.
JENNIFER HABERKORN: Thank you.
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