Will the Senate be more welcoming to Tavenner?
Last week, the White House announced that Dr. Donald Berwick, who has been the administrator of the Centers for Medicare and Medicaid Services (CMS) since 2010, will resign his position on December 2nd, which is four weeks before his recess appointment expires. Berwick was first nominated by President Obama in April of 2010, but the Senate, which is required by law to confirm the nomination, failed to do so. In fact, 42 Republican Senators, which is more than enough to block the appointment, asked Obama to withdraw the nomination because they opposed Berwick’s praises of Great Britain’s socialized healthcare system. Many Republicans pledged to block Berwick’s confirmation as CMS administrator. Although many Democratic Senators praised Berwick for his innovative ideas and efforts to improve the healthcare system by carrying out Obama’s health reform bill, they did not make aggressive attempts to confirm the nomination.
The Obama administration has nominated Marilyn Tavenner, who has been the principal deputy administrator of CMS since February 2010, to be Berwick’s successor. She will serve as interim administrator until the Senate votes to confirm her as the new leader. Tavenner has practiced as a nurse, a hospital executive, the secretary of the Virginia Department of Health and Human Resources and served as acting CMS administrator before Obama nominated Berwick in 2010. She is recognized more for her effective management style than her policy stances, as Berwick was. It is still unclear whether Tavenner will face the same Republican opposition as Berwick.
Unlike Berwick, Tavenner is recognized as a pragmatist and has not yet been criticized for radical policy changes, but she will not have an easy time facing the Senate in the nomination hearings. Tavenner has kept a low profile in CMS, and she never testified before Congress during the federal health reform law hearings. Working quietly behind the scenes, she has been described as a “chief implementer” of the health reform law, overseeing the development of rules and overhauling payment systems.
In Berwick’s case, Obama bypassed the traditional Senate confirmation by allowing Berwick a recess appointment. The Senate has a few months to fully scrutinize Tavenner before it votes to confirm the nomination in the spring. Though it is too early to tell whether the Republican Senators will be more welcoming to Tavenner than Berwick, many Republicans outside of Congress approve the appointment. The American Medical Association also released a statement of their approval of Tavenner:
“We have worked extensively with her in her role as deputy administrator, and she has been fair, knowledgeable and open to dialogue. With all the changes and challenges facing the Medicare and Medicaid programs, CMS needs stable leadership, and Marilyn Tavenner has the skills and experience to provide it.”
We can expect Tavenner to follow the same path as Berwick, but possibly her management style will cross party lines and gain the approval of both Republican and Democratic Senators.
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