Ruben King-Shaw Jr., heir apparent to Tom Scully, administrator of the Centers for Medicare and Medicaid Services, resigned from his post as the agency's deputy administrator last week in a move that didn't take many by surprise.
King-Shaw, 41, was appointed to his job at the CMS in April 2001. At the agency, he has been known as accessible and collegial, and his decision to resign was because of -in large part-personal financial considerations, sources said.
King-Shaw is the latest in a string of high-level officials to leave HHS in recent months. In February, Bobby Jindal, former HHS assistant secretary for planning and evaluation, left his job to return to Louisiana, where many expect him to run for governor.
In March, HHS Inspector General Janet Rehnquist resigned after a tumultuous tenure that included carrying a gun into her office and allegations of professional misconduct.
Few lobbyists or lawmakers expected significant fallout from King-Shaw's resignation, especially since he has been assigned almost full time to the Department of the Treasury for the past four months, where he has worked on President Bush's proposals to expand health insurance coverage with tax credits (April 7, p. 34).
Some said King-Shaw's outreach efforts and his ability to communicate with providers will be missed.
In an e-mail to the CMS staff last week, King-Shaw said, "In order to meet my responsibilities to my family, to fulfill my duties as leader of the Bush administration's healthcare tax credit strategies, and to serve the president in other ways, it is necessary and appropriate that I relinquish my position."
For King-Shaw, the decision to leave was "98% personal," Scully said. "I was pleading with him to hang in as long as he could," said Scully, who had expected King-Shaw to eventually take his place at the agency.
A replacement for King-Shaw hasn't been named, and the selection process is just now beginning, according to the CMS. Leslie Norwalk, the CMS' counselor and policy director, took on some of King-Shaw's duties during his time at the treasury, but she hasn't been named acting deputy administrator, a CMS spokeswoman said.
Lobbyists and others insisted last week that there is no pattern to the resignations, and each one is because of unique circumstances. With two children, King-Shaw had to make difficult financial choices, several sources said.
King-Shaw could not be reached for comment by deadline, and it was unclear what his next career steps will be.