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Top Obamacare official Tavenner calls it quits

Marilyn Tavenner
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Marilyn Tavenner

A woman who played a key role in the roll-out of Obamacare—and oversaw the massive government-run Medicare and Medicaid programs—unexpectedly resigned Friday after two often-tumultuous years..

Marilyn Tavenner, administrator for the federal Centers for Medicare and Medicaid Services, emailed staffers Friday to tell them she will leave her post at the end of February.

Tavenner's exit will come two weeks after the close of the second open-enrollment season for Obamacare health insurance plans.

Her boss, Health and Human Services Secretary Sylvia Burwell, credited Tavenner on Friday with being "a big part of the reason why, as of this past spring, roughly 10 million Americans had gained health coverage since last year—the largest increase in four decades."

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Tavenner will be replaced as administrator on an interim basis by Andy Slavitt, the former top Unitedhealth Group executive who is currently second-in-command at CMS.

In an email to CMS staff Friday, Tavenner wrote, "It is with sadness and mixed emotions that I write to tell you that February will be my last month serving as the administrator for CMS. I have great pride and joy knowing all that we have accomplished together since I came on board five years ago in February of 2010."

Tavenner did not say why she is stepping down, and her departure came as something of a surprise.

But an HHS official noted, "She has been working a 24/7-job for five years. She plans to take some time off and then will look at the opportunities ahead of her."

A former executive at the Hospital Corporation of America who had begun her career as a nurse, Tavenner joined CMS in 2010. She was confirmed as head of the agency, which has an $820 billion budget, in May 2013 after serving as principal deputy administrator, and then acting administrator.

Troubled Roll-out

Tavenner's tenure will be remembered primarily for including the implementation of the Affordable Care Act, which included the disastrous October 2013 launch of the federal Obamacare health insurance exchange HealthCare.gov.

That site was unable for two months to enroll significant numbers of people because of widespread technological problems.

Although a massive repair effort fixed HealthCare.gov well enough that it was able to enroll millions of people by April 2014, Tavenner and other officials in the Health and Human Services Department remained tarnished by the botched roll-out.

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Last year, Tavenner was blasted by Republican critics of Obamacare and others when it was revealed that she had publicly overstated Obamacare enrollment tallies as of the summer by nearly 400,000 people nationally. HHS said the gaffe resulted from mistakenly including dental insurance plan enrollments in the tally of people with health insurance.

Tavenner's prior boss, Kathleen Sebelius, left as HHS secretary last spring after about 8 million people signed up nationally for Obamacare plans. While that tally was lauded by the Obama administration as a sign of success for the Affordable Care Act, Sebelius, like Tavenner, remained bruised by criticism for having earlier opened an enrollment web site that did not work as designed at first.

Andrew Slavitt
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Andrew Slavitt

The current Obamacare enrollment season has gone much more smoothly on the federal exchange, which serves customers in the 37 states not running their own insurance marketplaces. HealthCare.gov has already signed up more people for coverage in 2015, nearly 6.8 million, than were enrolled in the entire nation as of October.

Burwell, in an email to staff Friday, wrote, "I hope you will join me in thanking Marilyn for her exemplary service, leadership, and historic record of accomplishment."

"Marilyn delivered historic results at the helm of CMS," Burwell wrote.

"It goes without saying that Marilyn will be remembered for her leadership in opening the Health Insurance Marketplace. In so doing, she worked day and night so that millions of Americans could finally obtain the security and peace of mind of quality health insurance at a price they could afford," Burwell wrote. "It's a measure of her tenacity and dedication that after the tough initial roll-out of HealthCare.gov, she helped right the ship, bringing aboard a systems integrator and overseeing an overhaul of the website."

"Had to go"

But Rep. Darrell Issa, the California Republican who until recently chaired the House Oversight Committee, said Tavenner's departure was overdue.

"Tavenner had to go," said Issa. "She presided over [CMS] as it deceptively padded the Obamacare enrollment numbers"

"It was a deplorable example of an agency trying to scam the American people.They weren't successful this time because of Congressional oversight. We deserve better," he said.

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Kinder words came from Sen. Chuck Grassley, (R-IA), a former Finance Committee chairman who said, "I've had a positive working relationship with Administrator Tavenner. I respect her abilities and her willingness to engage in open and often productive conversation."

"CMS administrator is a tough job under regular circumstances, and hers was especially hard in implementing a misguided new health care law," Grassley said. "I wish her well."

Other accomplishments

Although Obamacare got much attention during Tavenner's tenure, her agency also oversees two other larger health-care programs—Medicare, which mainly provides health coverage to senior citizens, and Medicaid, which provides such coverage to poor people.

"CMS has always been 'the biggest payer of healthcare services in the United States' and that in and of itself is a huge and complex responsibility for any Administrator and his or her team to manage," Tavenner wrote in her email to staff.

During Tavenner's time at CMS, Medicaid programs were expanded in 27 states and the District of Columbia to allow nearly all poor adults to obtain coverage if they applied. So-called Medicaid expansion is a key part of the Affordable Care Act, and has been credited to with adding millions of people to the rolls of the insured in the past year or so.

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Burwell wrote that under Tavenner's watch "the solvency of the Medicare Trust Funds was extended to 2030. In addition, her work on health care quality helped our nation achieve a 17 percent reduction in hospital acquired conditions – saving an estimated 50,000 lives and $12 billion in health care costs."

"Marilyn led the effort to accelerate the development and expansion of innovative new health care payment and delivery models. And thanks to her efforts, CMS is a government leader in the use of predictive analytics to help combat waste, fraud and abuse," Burwell wrote.