As administrator of the Centers for Medicare and Medicaid Services in the midst of the biggest crisis in the agency’s 48-year history, Marilyn Tavenner is tasked with implementing one of the most politically polarizing laws ever. Not to mention that the Obamacare rollout is not going so well.
Yet Tavenner herself has been spared much of the blame for what all sides are calling a calamity — and, even now, she retains much of the bipartisan support she had when she was confirmed by the Senate on a 91-7 vote in May. She is a former hospital administrator and top state health official in Virginia, and her extensive career outside Washington seems to have shielded her from much of its wrath.
“She had no real exposure to politics,” said Laurens Sartoris, president of the Virginia Hospital and Healthcare Association, who has known and worked with Tavenner for decades. “Obviously, to survive, you have to have good political skills and sensitivities, but I don’t think anyone would characterize her as a politician. She’s someone who is a competent administrator — she runs organizations to get certain results. That approach is really an apolitical one.”
Born in Martinsville, Va., in 1951, Tavenner spent the majority of her career in Virginia. She began as a nurse at the Johnston Willis Hospital in Richmond in 1981 and rose to become its CEO 12 years later. She then climbed the ladder in the parent company, the Hospital Corporation of America, becoming president of HCA’s Central Atlantic Division and its 20 hospitals in 2001 and later moving up to group president of outpatient services.
In 2006, Virginia’s Democratic governor, now-Sen. Tim Kaine, appointed Tavenner secretary of Health and Human Resources, putting her in charge of a department with a $9 billion annual budget and 18,000 employees. Four years later, she became the principal deputy administrator at CMS and then was named acting administrator in December 2011; a year and a half after that, the Senate overwhelmingly confirmed her appointment as CMS administrator.
Those who have worked with Tavenner describe her as smart, hard-working, and direct. “She’s the consummate professional,” said Patrick Finnerty, who was Medicaid director in Virginia under Tavenner. “Her approach was, an issue comes up, we fix it, and we move on.”
The fix-it-and-move-on way of doing business is proving difficult with the problems plaguing HealthCare.gov, and Tavenner has testified at a couple of lengthy congressional hearings in recent weeks — experiences she clearly would have preferred to avoid.
“There are two things Marilyn is not into,” Sartoris said. “The first is having more material before herself or someone else than what is needed to make the right decision. Second is, she doesn’t like to hear herself talk. She’s not one to walk in a room and search for the microphone.”
In both the House and the Senate committee hearings, the lawmakers often spoke more than the administrator. At a hearing of the House Ways and Means Committee, tensions ran high between panel members, but even staunch opponents of Obamacare were surprisingly pleasant to Tavenner.
Of course, her long working relationship with House Majority Leader Eric Cantor, R-Va., doesn’t hurt. “Thank you so much for being here,” Rep. Tim Griffin, R-Ark., said as he greeted Tavenner at the Ways and Means hearing. “I’ve heard a lot of good things about your work from Leader Cantor. So thank you for being here, and I wish you well.”
Cantor, who worked with her in Richmond, has endorsed Tavenner in the past, and he focuses blame for the HealthCare.gov rollout on Health and Human Services Secretary Kathleen Sebelius.
Ways and Means Committee ranking member Sander Levin, D-Mich., said Tavenner’s bipartisan appeal is likely a result of her professional history. “She’s not someone with a strong elective or political background,” Levin said. Sebelius, on the other hand, is a member of President Obama’s Cabinet, he said, “and the president has been the main target.”
“I think the difficulties have made her all the more determined to try to make the [Affordable Care Act] work,” Levin said. “[Tavenner] has devoted her entire professional career to making health care more accessible. There’s no question about her dedication.”
While calls for Sebelius’s resignation have been loud and numerous, lawmakers have been less eager to point fingers at Tavenner, even though it is her name on oft-cited CMS documents authorizing the Oct. 1 launch of the federal exchange website despite some concerns about potential security risks.
“Senator Hatch has always found Marilyn Tavenner to be bright and capable,” Julia Lawless, spokeswoman for Sen. Orrin Hatch, R-Utah, wrote in an email. To be “tasked with overseeing a massive bureaucracy like the one at CMS is certainly no small feat.”
As ranking member of the Senate Finance Committee, Hatch supported Tavenner in her confirmation hearing. Even Sen. Pat Roberts, R-Kan. — an old family friend of Sebelius’s who is also on the Finance Committee — has called on the secretary to resign yet kept mum on Tavenner.
While Tavenner’s role overseeing implementation of the health care law is now certainly unique, admirers believe she will continue to approach her work with the same focus she had in her hospital years. “I would assume Marilyn will do what she always does,” Sartoris said, “which is buckle down and keep the program moving along.”
Sartoris added, unprompted, that Tavenner has the right attitude about the job — and about life in general.
“When you’re watching her sit at that table, when there’s not a lot of humor in the room, it may be hard to comprehend,” he said. “But she has a wonderful sense of humor and perspective on things. You have to have one — in that stew pot, you would go nuts if you weren’t able to take a step back. I’d be terrified to sit in that seat.”