Smooth sailing so far for Medicare nominee

 Interest groups are lining up behind President Obama’s nominee to lead the federal Medicare agency amid signs she might survive a vetting from Senate Republicans.  

The White House announced last week that it would nominate Marilyn Tavenner to lead the Centers for Medicare and Medicaid Services (CMS) after Administrator Don Berwick steps down on Dec. 2.


Republicans’ initial response to the pick has been muted, a marked contrast to the firestorm that greeted Berwick’s nomination. After Senate Republicans blocked Berwick, Obama installed him at the agency with a recess appointment in the summer of 2010.

Current and former Republican staffers said the White House seems to have aimed for a more vanilla pick this time around and might well have found one in Tavenner, now the deputy at CMS.

Tavenner’s background is in healthcare policy. She worked in a hospital chain and ran Virginia’s health department under then-Gov. Tim KaineTimothy (Tim) Michael KaineOvernight Health Care — Presented by That's Medicaid — House passes sweeping Pelosi bill to lower drug prices | Senate confirms Trump FDA pick | Trump officials approve Medicaid work requirements in South Carolina Senate confirms Trump's nominee to lead FDA Democrats worried by Jeremy Corbyn's UK rise amid anti-Semitism MORE (D) before joining CMS about two years ago.

That’s a notable contrast from Berwick, whose background was in academia. Republican senators seized on favorable comments Berwick made about the British healthcare system and accused him of wanting to ration care. Rep. Phil GingreyJohn (Phil) Phillip Gingrey2017's top health care stories, from ObamaCare to opioids Beating the drum on healthcare Former GOP chairman joins K Street MORE (R-Ga.) compared Berwick to Don Corleone.

Democrats say they are optimistic that the Senate will confirm Tavenner, and Republicans said Monday that they did not see any immediate red flags with Obama’s pick.

Sen. Orrin HatchOrrin Grant HatchKey Republicans say Biden can break Washington gridlock Trump awards Medal of Freedom to racing industry icon Roger Penske Trump holds more Medal of Freedom ceremonies than predecessors but awards fewer medals MORE (Utah), the ranking Republican on the Senate Finance Committee, said the panel would carefully examine Tavenner’s record. Other Republicans who were harshly critical of Berwick, including Sen. John BarrassoJohn Anthony BarrassoLife after Yucca Mountain: The time has come to reset US nuclear waste policy Trump announces restart to Taliban peace talks in surprise Afghanistan visit Centrist Democrats seize on state election wins to rail against Warren's agenda MORE (Wyo.), have said they’re withholding judgment about the new nominee.

Tavenner has quickly garnered support from key interest groups, including hospitals and doctors. The American Medical Association (AMA) formally backed her appointment on Monday.

“We have worked extensively with her in her role as deputy administrator, and she has been fair, knowledgeable and open to dialogue,” AMA President Peter Carmel said in a statement. “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.”

The Federation of American Hospitals also lent its support, as did the Alliance for Quality Nursing Home Care. The Association of American Medical Colleges praised Tavenner earlier.

“Ms. Tavenner’s successful career is characterized by her willingness to go the extra mile and to reach across the aisle to achieve results,” FAH President Chip Kahn said. “She is an ideal candidate to head CMS, and we encourage the Senate to approve her nomination quickly.

Lobbyists, consultants and congressional aides noted that it’s still early in the nomination process, so Tavenner is hardly out of the woods. But she was widely expected to succeed Berwick, so at least some degree of vetting likely began before she was announced, they said. 

Berwick came into CMS passionate about delivery-system reform — trying to improve the quality of healthcare while lowering costs, often by trying to better coordinate various services. He took ownership of specific initiatives, such as accountable care organizations, that sought to advance his vision of a better healthcare system.

Tavenner, by contrast, has served largely in an operational capacity, lobbyists and staffers said. Her political experience is with Democrats, and as CMS administrator she would have a major role in implementing healthcare reform. Her record as an implementer could help deflect concerns about specific programs or initiatives during the confirmation process.