Medicare gets its first confirmed leader in nearly a decade

May 15, 2013

The Senate confirmed Marilyn Tavenner as Medicare administrator on a 91-7 vote.

Moments ago, the Senate did something it has not done in nearly a decade: It confirmed a leader for the Center for Medicare and Medicaid Services.

Obama nominee Marilyn Tavenner received a 91 to 7 vote on the Senate floor to run an agency that, since 2006, has been without a confirmed leader. Her position, overseeing a $1 trillion agency that administers health benefits to millions, has long been considered too politically volatile to  fill.

Tavenner, a former hospital executive, managed to thread the needle. She spent more than  a year as Medicare's deputy administrator and apparently impressed Senate Republicans. Dozens of health-care associations endorsed her nomination, as did a seven former Medicare heads (three Republicans, four Democrats). As one told me, if Tavenner couldn't get confirmed, then not even "Mother Teresa or Ghandi" could get the Senate's blessing.

Former Medicare administrators say that confirmation is important in running an agency. When the White House knows you're going to be around for a significant amount of time and have the Senate's backing, they say, it makes it easier to stand firm on crucial fights.

“The basic work will get done either way,” Bruce Vladeck, President Bill Clinton’s former Medicare administrator, told me in an interview  this year. “What’s really important is it gives someone whose primary concern is Medicare and Medicaid a little more ability and standing to push back against others in the executive branch. The stature of a Senate confirmation does give a little extra standing.”

Now, Tavenner has that. For a bit more background, you can read our interview from a few months back and a profile from 2011, which includes a story of how Tavenner brought a patient back from the dead.

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Dylan Matthews | May 15, 2013