Obamacare official to leave after successes, messes

WASHINGTON — Marilyn Tavenner, the Obama administration official responsible for implementing the Affordable Care Act, will quit at the end of February.

Health and Human Services Secretary Sylvia Burwell made the announcement in an e-mail to agency employees Friday.

Tavenner was the director of the Centers for Medicare and Medicaid Services — first in an acting capacity in 2011, then confirmed by the Senate in 2013.

“It goes without saying that Marilyn will be remembered for her leadership in opening the health insurance marketplace,” Burwell said.

Tavenner, a nurse who was a hospital administrator before joining the government, was credited by Burwell for having the “tenacity and dedication” needed to help “right the ship” after the disastrous rollout of HealthCare.gov.

“People could perhaps expect better administration, more transparency from CMS during Marilyn’s tenure, but her hands were tied,” said health care consultant Kip Piper, a former federal and state health care official. “Most will recognize that the ACA problems originated with the law itself and subsequent decisions, delays and diffuse delegation by higher-ups in the Obama administration.”

Burwell said the agency’s principal deputy administrator, Andy Slavitt, would become acting administrator.

“She’s been there for a long time, had a good tenure and did a lot of really important things,” said Dan Mendelson, CEO of research and consulting firm Avalere Health, who knows Tavenner well. “This is a reasonable time for her to leave. Someone can come in, take this job and do it for another two years.”

After helping to oversee the disastrous rollout of HealthCare.gov in October 2013, Tavenner faced more criticism on Capitol Hill when it was disclosed in November 2014 that ACA enrollment numbers had been boosted by nearly 400,000 when those who also signed up for dental plans were counted twice.

After the Republican takeover of the Senate and efforts to dismantle some or all of the sweeping health law, Tavenner faced the prospect of countless more testy congressional hearings. Mendelson said he doubts that swayed her decision.

“That wouldn’t have spooked Marilyn. Partisanship is just a fact of life for political appointees, and you just have to deal with it,” said Mendelson, who was the health chief at the Office of Management and Budget in the Clinton administration. “What happens is that when you’ve accomplished as much as she has, you start thinking about the future.”

Rep. Darrell Issa, R-Calif., who chaired the House Oversight Committee when it held a hearing on the enrollment number problems in December, said in a statement that she “had to go.”

“She presided over HHS as it deceptively padded the Obamacare enrollment numbers,” he said. “It was a deplorable example of an agency trying to scam the American people.”

Tavenner didn’t explain the reason for her departure in an e-mail to staff Friday morning.

“I feel fortunate to leave here with a great sense of accomplishment, a wealth of knowledge, many new friends and the comfort of knowing that the citizens of this country and I are in great hands with all of you and your incredible drive and commitment to continue transforming our health care system,” she wrote in the lengthy e-mail that mostly detailed agency accomplishments.

She cited the agency’s work in increasing access to health care coverage — despite the effort’s “many challenges” — combating Medicare and Medicaid fraud and helping to control health care costs, among other issues.

Larry Levitt, senior vice president at the Kaiser Family Foundation, noted that “much of what CMS has had to do in recent years has been in a very public fishbowl and a divisive political environment.”

Tavenner hasn’t received public recognition for “under-the-radar initiatives that have gone more smoothly,” said Levitt, a former senior health policy adviser to the White House and HHS in the Clinton administration.

Many of Tavenner’s challenges were out of her control, said consultant Piper, who was a senior adviser to the CMS administrator during the George W. Bush administration.

“CMS is an imperfect agency with an impossible job,” he said. “Assessing the tenure of a CMS administrator must reflect these immutable facts.”