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Senator Tom Harkin, Iowa Democrat
Harkin

Democratic senator blocks vote on Tavenner nomination


By Rich Daly
Posted: April 24, 2013 - 5:15 pm ET
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(Story updated at 5:15 p.m. ET.)

A Democratic senator has indefinitely blocked a Senate vote on Marilyn Tavenner's nomination to head the CMS.

Sen. Tom Harkin (D-Iowa), chairman of the Senate Health, Education, Labor and Pensions Committee, placed a hold on Tavenner's nomination to keep the Senate from voting on it, his spokeswoman confirmed Wednesday. She declined to specify why Harkin blocked a vote on Tavenner but alluded to his concerns raised at an earlier hearing.

At the Senate Appropriations Labor, HHS Subcommittee hearing on Wednesday, Harkin blasted a proposal in President Barack Obama's recently introduced fiscal 2014 budget to cut funding already allocated for an illness prevention fund.

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“However, I am greatly disappointed that the administration chose to help pay for the Affordable Care Act in fiscal year 2013 by raiding the Public Health and Prevention Fund,” Harkin said. “The Prevention Fund works. Thanks to this funding, more children are being immunized. More people are quitting smoking. More communities are fighting chronic disease. More people are being screened for hepatitis C. Robbing prevention when we know these efforts can improve people's health and lower healthcare costs goes against the very mission of healthcare reform.”

Tavenner won voice vote approval on Tuesday from the Senate Finance Committee, clearing the way for a vote by the full Senate. Senate Majority Leader Harry Reid said later that day that he was unsure when he would schedule a vote on Tavenner but highlighted the broad bipartisan support for her.

House Majority Leader Eric Cantor (R-Va.), who has strongly backed his fellow Virginian's nomination, tweeted his support for Harkin's position on the prevention fund Wednesday, even as he urged confirmation of Tavenner.

The administration's fiscal 2014 budget proposed diverting $453.8 million from the prevention fund to the CMS for enrollment in the health exchanges, which will begin enrollment on Oct. 1.

Those proposed fund cuts were concerning enough to some backers of the fund to draw support for Harkin's actions.

“He's using all of the legislative tools in his tool kit to get the administration's attention and make an important point about the prevention fund and its importance,” Dr. Georges Benjamin, executive director of the American Public Health Association, said in an interview.

Benjamin supports Tavenner but expects Harkin will maintain the hold “long enough to get the administration's attention but not long enough to impede her confirmation.”

A White House spokesman did not respond to requests for comment on Harkin's hold.

Dr. Paul Jarris, executive director of the Association of State and Territorial Health Officials, said in an interview that his group was generally supportive of Harkin's efforts to champion the prevention fund but would not address his Tavenner hold.

“Obviously he and we are extremely disappointed when we see money being diverted from its original intent into other purposes,” Jarris said.

Jarris and other prevention advocates were critical of the HHS for previously transferring $332 million from the fund to help launch the exchanges.

”For example, the diversion of $332 million supporting prevention and public health into the exchanges is certainly something we understand his anger over and we share the concern about the negative and harmful impact that will have on our country,” Jarris said.

Although Senate Democratic staff said a resolution to the hold will come down to discussions between Harkin and the White House, the senator is likely to hear from his colleagues.

"I'm going to have a conversation with him," Sen. Mark Warner (D-Va.) told Modern Healthcare when asked about Harkin's hold.

Warner lavished Tavenner with praise when he introduced his fellow Virginian at her confirmation hearing last week.


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