U.S. Senate Confirms Tavenner as Permanent CMS Administrator
The Senate on Wednesday voted 91-7 to confirm Marilyn Tavenner -- CMS' acting administrator -- as the agency's first permanent chief since 2006, Reuters reports (Morgan, Reuters, 5/15). Seven Republican senators -- including Minority Leader Mitch McConnell (Ky.) -- voted against her nomination (Cox, "Floor Action Blog," The Hill, 5/15).
Tavenner, who has been serving as acting administrator since late 2011, is widely regarded as playing an integral role in the operations of government health insurance programs that cover more than 100 million U.S. residents and the implementation of the Affordable Care Act (Levey, "Politics Now," Los Angeles Times, 5/15).
During a Senate Finance Committee hearing in April, Tavenner said she would run the agency "as a business and act like business partners" in collaboration with stakeholders. "We have an $820 billion dollar business to run that a large amount of this country has a stake in, from beneficiaries to providers to hospitals to insurance companies to Congress to the administration to our CMS employees and contractors," she said (Clarke, Reuters, 4/9).
Nomination Hits Bump Toward Confirmation
During the April hearing, Senate Health, Education, Labor and Pensions Committee Chair Tom Harkin (D-Iowa) expressed concern with the administration's decision to use money allocated for ACA's Prevention and Public Health fund in fiscal year 2013 to pay for an insurance exchange navigators program (CQ Roll Call, 4/11).
At issue is about $332 million that the White House intends to use from the fund for outreach and education about the exchanges. At the hearing, Harkin said, "I believe the navigators need to be funded but to rob it from the prevention fund? ... We're not going to accept that." He noted that the administration had told him that no funding would be pulled from the prevention and public health fund, which he had championed during the health reform debate.
In late April, Harkin announced that he would indefinitely delay a Senate vote on Tavenner's nomination over the funding issue (Daly, Modern Healthcare, 4/24). However, in remarks on the Senate floor on May 7, Harkin announced that he would lift the hold. He said the White House had made it "clear that it will not reverse course with regard to its raid on the prevention fund."
He said, "I do not want to interfere with the important work of [CMS]," adding that he believes Tavenner "is strongly qualified to be the next CMS administrator and that it is urgent to have an effective leader at the helm of CMS as we enter a critical stage in implementing the [ACA]" (California Healthline, 5/8).
Lawmakers, Former CMS Chief Weigh In on Tavenner's Confirmation
Prior to Thursday's final vote, Sen. Tim Kaine (D-Va.) said Tavenner was the right pick because she would bring a patient-focused "nurse's attitude" to CMS. In addition, she is an "expert" on finding health care cost savings, Kaine added ("Floor Action Blog," The Hill, 5/15).
Sen. Mark Warner (D-Va.) -- a former governor of Virginia, where Tavenner served as health secretary -- cited Tavenner's experience as a hospital executive and in the private sector, adding,Â "She understands the impacts that rules and regulations have in the real world" (Daly, Modern Healthcare, 5/15).
Sen. Orrin Hatch (R-Utah) -- ranking member of the Senate Finance Committee -- said Tavenner "has shown a willingness to work with members of both parties, which is a welcome development, particularly under this administration" (Pear, New York Times, 5/15).
Meanwhile, McConnell said, "Tavenner is a smart, capable public servant," but he argued that CMS' main role in implementing the ACA has changed the focus of the administrator's job. "[P]rotecting and strengthening Medicare and Medicaid deserve the full-time attention of a CMS administrator," he added (Reuters, 5/15).
Bruce Vladeck, a former CMS administrator in the Clinton administration, noted that the "stature of a Senate confirmation does give a little extra standing" by giving "someone whose primary concern is Medicare and Medicaid a little more ability and standing to push back against others in the executive branch" (Kliff, "Wonkblog," Washington Post, 5/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.