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Obama's Medicare Chief to Step Down

By Adriel Bettelheim, CQ Roll Call

January 16, 2015 -- Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner will step down as chief of the government's two big health programs in February, she said in an email to agency staff at the close of last week.

The former nurse and hospital executive was the first Senate-approved administrator of CMS in nine years. She was confirmed in a 91-7 vote in May 2013, even as Republicans were unleashing criticism of the health care law (PL 111-148, PL 111-152) that Tavenner was charged with implementing.

"I feel fortunate to leave here with a great sense of accomplishment, a wealth of knowledge, many new friends and the comfort of knowing that the citizens of this country and I are in great hands with all of you and your incredible drive and commitment to continue transforming our healthcare system," Tavenner wrote in her message to CMS staff.

An agency spokesman said Tavenner planned to take some time off before exploring other opportunities.

Her departure could trigger a contentious confirmation process with the Republican-controlled Senate over a successor. CMS issues rules clarifying how insurance companies, drugmakers, hospitals, and other providers of medical services operate under the health law. It also serves as the biggest purchaser of health services in the United States.

Health and Human Services Secretary Sylvia Mathews Burwell said Principal Deputy Administrator Andrew Slavitt will serve as acting administrator.

Tavenner was the last major administration appointee outside the White House who was involved with implementing the health law after it was enacted in 2010. Many other CMS officials left in 2013 and 2014. 

Her departure comes as a number of key federal Medicaid officials are also on the way out, including CMS Deputy Administrator Cindy Mann, who has overseen Medicaid policy for the Obama administration since the beginning of the first term. 

Tavenner drew quick praise from Senate Finance Committee Chairman Orrin G. Hatch, R-Utah, whose panel has jurisdiction over Medicare and Medicaid.

"Marilyn has done a great job in a very difficult position under near impossible circumstances," Hatch said in his statement. "She has proven herself to be a strong leader and a straight-shooter who brought in much-needed private sector sensibility into the agency."

Senate Majority Leader Mitch McConnell, R-Ky., called on President Barack Obama to nominate a successor who can focus on seniors and other vulnerable populations and who won't be burdened with "implementing a gigantic, unworkable law that hurts hardworking Americans." 

America's Health Insurance Plans President and CEO Karen Ignagni said Tavenner "leaves behind a legacy of leadership at a time of unprecedented change in our health care system.

"She was a thoughtful strategist and balanced manager who time and time again rolled up her sleeves to work with all stakeholders on solutions to advance patient care," Ignagni said in a statement.

Timothy S. Jost, a Washington and Lee University law professor and supporter of the health law, said Tavenner's departure comes at a time when things have improved for the federal health law exchange, whose glitch-filled launch drew widespread criticism.

" has just turned around 180 degrees in the last year," Jost said in an interview.

Sara Rosenbaum, a health law and policy professor at the George Washington University, said that "despite the initial setbacks in the operation of, she can point with great pride to the implementation of the new marketplace, the expansion of Medicaid to millions of new beneficiaries, and the introduction of landmark Medicare reforms in organization and financing."

But California Republican Darrell Issa, who chaired the House Oversight and Government Reform Committee in the 113th Congress, said in a statement that Tavenner's departure was necessary. Tavenner apologized before his panel in December for previously testifying that about 7.3 million people had paid and enrolled through the exchanges authorized by the health law. The committee had found that nearly 400,000 sign-ups were from dental plans—which Tavenner said she believed had been inadvertent error—prompting CMS to revise its figures.

"Tavenner had to go," Issa said. "She presided over HHS as it deceptively padded the Obamacare enrollment numbers. It was a deplorable example of an agency trying to scam the American people. They weren't successful this time because of congressional oversight. We deserve better."

Tavenner started her health care career as a nurse and rose steadily through the ranks at Hospital Corp. of America. She later became Virginia's secretary of health and human resources under then Gov. Tim Kaine, now the state's junior senator.

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