Medicare Chief to Resign After Obamacare Stumbles, Recovery

By Alex Wayne

Photographer: Andrew Harrer/Bloomberg

Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, will... Read More

Marilyn Tavenner, the U.S. official who directed the stumbling roll-out of Obamacare as well as its recovery in recent months, will resign as head of the Centers for Medicare and Medicaid Services.
Tavenner said in an e-mail to staff that she’ll step down at the end of next month. She didn’t give her reasons for leaving. Andy Slavitt, a former UnitedHealth Group Inc. executive who is the agency’s second highest-ranking official, will move into Tavenner’s job on a temporary basis, Health and Human Services Secretary Sylvia Mathews Burwell said in a separate e-mail to staff.
Tavenner took over CMS in 2011, the year after President Barack Obama signed the Patient Protection and Affordable Care Act. Her departure comes after some of the worst missteps in the agency’s recent history, as implementation of the health-care law proved vexing for Tavenner and her staff.
“We had many additional challenges put before us to look at ways to improve quality, reduce costs, eliminate fraud, increase transparency, and provide access to millions more of
our fellow Americans,” Tavenner said in her e-mail. “With those changes came a whole new set of responsibilities and a spotlight that brightly shown on all of us.”
Along with the Affordable Care Act, CMS also runs Medicare, the health program for the elderly and disabled, and Medicaid, for low-income people.

Flawed Rollout

After Republicans took over the House of Representatives in 2011, they denied the Obama administration’s requests for additional money to finance the health law’s enactment. Federal officials and White House allies have blamed the government’s struggles with the law, in part, on a shortage of funding.
Tavenner “worked tirelessly” at a time when her job had been made “more difficult, complex and politicized than ever before,” Senator Ron Wyden of Oregon, the senior Democrat on the Finance Committee, said in a statement.
As head of the agency, Tavenner was arguably the person most responsible for construction of healthcare.gov, the federal health insurance website that collapsed when it opened for business in October 2013. A UnitedHealth Group unit -- then run by Slavitt -- was hired to lead repairs.
In November of last year, Tavenner also acknowledged that her agency had made a mistake in its calculation of the number of people enrolled under Obamacare for 2014. About 393,000 individuals with both health and dental coverage were “inadvertently counted twice,” she said in a letter to Representative Darrell Issa, a California Republican whose committee discovered the error.
“Tavenner had to go,” Issa said in a statement today. “She presided over HHS as it deceptively padded the Obamacare enrollment numbers.”

Right Time

Tavenner decided that the time was right for her to leave, a spokeswoman for her agency, Lori Lodes, said in an e-mail.
The second enrollment period for the Affordable Care Act will close Feb. 15, and heathcare.gov is operating well this year, without the errors and bugs that hobbled the site last time. About 6.8 million people in states covered by the federal site have so far signed up for or renewed 2015 coverage 2015, the Health and Human Services Department said Jan. 14.
“Marilyn decided to leave after devoting the last five years and countless hours to fulfilling CMS’s mission,” Lodes said. “The organization is stronger and in a better place than when she joined it.”

Tough to Fill

Tavenner was acting administrator of CMS since 2011 and became the official head in May 2013. In her e-mail today, she focused on the agency’s progress in expanding insurance coverage through Medicaid and the Affordable Care Act.
“We came together and faced the challenges and are now providing millions of people with access to an affordable, high quality –- and in some cases a lifesaving -- health-care plan,” she said.
Tavenner’s position has historically proved difficult to fill. Before the Senate confirmed her appointment, the Medicare agency hadn’t had a permanent administrator since October 2006. Obama’s first choice to run it, Donald Berwick, was blocked from a permanent appointment by Republicans who objected to his support for government-run health systems.
It isn’t clear how Slavitt would be received by Republicans, should Obama nominate him as Tavenner’s permanent replacement. He is largely unfamiliar to lawmakers, and his ties to UnitedHealth, which is a contractor for healthcare.gov and sells its plans to Medicare, Medicaid and Affordable Care Act customers, may complicate his confirmation.
“We will not have a personnel announcement today but are confident, when we have a nominee, he or she will be worthy of quick consideration and bipartisan support,” Jessica Santillo, a White House spokeswoman, said in an e-mail.