The Senate Finance Committee on Tuesday overwhelmingly lauded President Barack Obama’s nominee to run Medicare, Medicaid and even much of the health reform law.
Marilyn Tavenner, who has run the sprawling Centers for Medicare & Medicaid Services as acting administrator for well over a year, was praised by Republicans and Democrats during her confirmation hearing, indicating that she is likely to sail through the full Senate without a reprise of the nasty politics of the health law.
Senate Finance Committee Chairman Max Baucus (D-Mont.) told reporters that he hopes to hold a vote as soon as next week. She’d be the first CMS head to be confirmed since Mark McClellan, who served from 2004 to 2006 in the George W. Bush administration.
Even though CMS oversees much of Obamacare, those disputes were largely pushed aside as lawmakers focused on quizzing Tavenner on their pet health care issues.
Members of both parties did press her to provide more regular updates on implementation of the law. Republicans also demanded that the agency reveal the budget for setting up the health insurance exchanges — a figure the agency has been loath to release. Tavenner pledged to provide biweekly updates on the status of the law and said a price tag on the federal exchange is coming. “There will be a lot of people watching you, myself included,” Baucus said. “The administration and CMS need to implement health care reform the way Congress intended.”
Sen. Orrin Hatch (R-Utah), a consistent critic of the president’s health law, said he wants better communication between the Hill and Health and Human Services — but told Tavenner: “I believe you will be up to that challenge.”
The long-awaited confirmation hearing began on a congenial bipartisan note. House Majority Leader Eric Cantor (R-Va.) came to the Senate hearing to back Tavenner, whom he’s known for years, dating back to when she worked at the Hospital Corp. of America in his hometown of Richmond.
“I don’t think there is any secret that I differ with the Obama administration in a lot of matters in health care policy. Obviously, the issue of Obamacare remains very controversial,” Cantor said. “But if there is anyone that I trust to try to navigate the challenges, it is Marilyn Tavenner.”
Tavenner’s most pointed questions came from Sen. Chuck Grassley (R-Iowa), who demanded that she investigate how market-moving news about Medicare Advantage rates leaked — perhaps out of CMS.
Tavenner said she takes the leak seriously and is asking the inspector general to investigate as well as holding an internal review.
“Obviously, I have a lot of pride in our agency, so I don’t want to believe our agency leaked anything ever,” she said after the hearing. “We have a lot of market-sensitive information that we handle all the time, and for that reason, we’re very careful about it.”
Tavenner, a nurse and former hospital administrator, was named to run CMS after it became clear that her predecessor, Don Berwick, would never get confirmed amid intense health politics. But Tuesday’s hearing focused by and large on state-based issues. Sen. Robert Menendez (D-N.J.) asked Tavenner to reconsider rules to require insurers to cover autism and other behavioral health issues; Republican Sens. John Thune of South Dakota and Pat Roberts of Kansas demanded more attention to rural health; and Sen. Ben Cardin (D-Md.) asked Tavenner to rewrite regulations to broaden dental health benefits for children.
Tavenner’s hearing was remarkable not only because she was widely praised but also because of the contrast with prior nominees dragged down by politics.
Since McClellan left in 2006, a series of temporary and acting administrators has run the agency as presidents either avoided nominating anyone or watched their picks crumble. A Republican’s nomination during Bush’s tenure never made it to a vote, and the most recent Democrat to hold the job — Berwick — was blasted by the opposition for supposedly endorsing rationing health care, a characterization that he denied.
Tavenner was praised by both parties, and every indication is that she’ll be confirmed with broad support.
The broad support for Obama’s nominee to run CMS doesn’t mean that the politics of health reform have cooled completely. Instead, it reflects that Tavenner has no political skeletons in her closet and that lawmakers agree it’s time to have a permanent confirmed administrator in the position.
Although, a hearing hasn’t been held before now because of the volatile politics around health reform, according to a Senate Democratic aide. Tavenner was originally nominated in November 2011 — when health reform politics was red-hot. Time has passed, and the Supreme Court ruling and Obama’s reelection have ensured the law will be implemented — all of which has had a cooling effect on the boiling health reform politics.
And because Tavenner’s been at CMS for three years — as acting administrator and the No. 2 under Berwick — she’s a known quantity who has built relationships on the Hill, including with the key members of the Finance Committee.
“I’ve had three years of working inside the agency, so I’ve gotten to know more of them [in the context of] here’s an issue; is there a solution? And here’s a piece of the law I’m uncertain about; can you clarify it for me?” Tavenner said after the hearing. “So I think it has just been a matter of building those relationships over a few years, and I really appreciate it.”
April 10th, 2013