President Barack Obama's re-nomination of Marilyn Tavenner as administrator of the CMS on Thursday drew wide support from health industry leaders but an uncertain outlook on Capitol Hill.
Tavenner, who leads the agency in an acting capacity, was first nominated in 2011 following the resignation of Dr. Donald Berwick
, the previous acting administrator. Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee, opted not to advance her initial nomination and it expired at the end of the last Congress.
Health industry leaders pushed for her new nomination to advance.
“Marilyn's varied and rich background as a nurse, healthcare executive and government official at the state and national levels gives her a unique perspective and demonstrates that she is a very capable leader of the Medicare and Medicaid programs,” said Rich Umbdenstock, president and CEO of the American Hospital Association. “We enthusiastically support her nomination and look forward to continuing our work with Marilyn to improve healthcare in America.”
Chip Kahn, president and CEO of the Federation of American Hospitals, similarly praised Tavenner and urged a quick confirmation.
However, it is unclear whether her confirmation is imminent.
A spokeswoman for the Senate Finance Committee, which oversees her confirmation, declined to comment on a confirmation schedule.
Joe Antos, a health economist at the conservative American Enterprise Institute, said Tavenner is likely to receive confirmation because she is “minimally political” and highly qualified. However, any nomination hearing also is likely to feature broad and deep Republican criticisms of the Patient Protection and Affordable Care Act, many provisions of which Tavenner is responsible for implementing.
Such a focus on the underlying law was echoed in early Republican reactions to her re-nomination.
“With Medicare and Medicaid on an unsustainable fiscal path, the cost of healthcare continuing to rise, and with the implementation of the health law moving forward, there are many questions she'll need to fully answer before I decide whether or not to support her nomination,” said Sen. Orrin Hatch (R-Utah), ranking member of the Finance Committee.
Tavenner, former Virginia secretary of health and human services, has worked since her original nomination both to run the CMS and implement many complex provisions of the healthcare overhaul. Those tasks are much more easily handled, agreed former leaders of the agency and other health policy experts, with full confirmation.
“A confirmed administrator can be more forceful than an acting one,” said Paul Ginsburg, president of the Center for Studying Health System Change.
Ron Pollack, executive director of the liberal Families USA, agreed that the scale of the work the agency is undertaking, including overseeing the expansion of Medicaid and the launch of health insurance exchanges, requires a confirmed leader.
“Given the huge tasks ahead for the agency and her very remarkable record, it's my hope that the Senate will confirm her quickly,” he said.
Any possibility that President Barack Obama will appoint her to the position using a recess appointment received a warning from Sen. Chuck Grassley (R-Iowa), another member of the Finance Committee, who counseled against the “unconstitutional circumvention.”
“The Senate should give Ms. Tavenner every opportunity to show she is a worthy choice to lead the agency responsible for Medicare, Medicaid, the Children's Health Insurance Program, and a lot of the implementation of the Obama healthcare law,” he said.