The Senate Finance Committee on Tuesday approved President Obama's pick to lead the federal agency that runs Medicare and Medicaid, giving her a bipartisan boost amid the fiery debate over health care and entitlement spending.
The nomination of Marilyn Tavenner, acting administrator of the Centers for Medicare and Medicaid Services, now goes to the full Senate for approval. Her confirmation is all but assured.
Ms. Tavenner's fast-climbing career track has impressed Republicans and Democrats alike. She started as a nurse, worked her way up to become CEO of a Richmond hospital and then served in now-Sen. Tim Kaine's Cabinet when he was governor of Virginia.
On Tuesday, the committee approved Ms. Tavenner by a simple voice vote.
Chairman Max Baucus, Montana Democrat, said Ms. Tavenner is "one of the best," while ranking member Orrin G. Hatch, Utah Republican, deemed her an "excellent choice" to lead the agency that makes sure 100 million older and poor Americans have health coverage.
"It's the nation's largest insurer," Mr. Hatch said. "We need a permanent person there."
She would become the first permanent leader in years. Her predecessor, Donald Berwick, was given a recess appointment by Mr. Obama in 2010 but that expired in 2011, and it was clear Senate Republicans would block his formal confirmation.
If confirmed, Ms. Tavenner will serve at a crucial time for the agency. Mr. Obama's health care law will establish insurance marketplaces in all 50 states and expand the Medicaid programs of states that opt in, and the ballooning costs of health care entitlement programs are pivotal in debt-reduction talks.
Members of Congress also are trying to rewrite the way doctors are paid under Medicare. Under current law, payments are scheduled to be cut by more than 25 percent in order to contain costs, but lawmakers regularly have passed one-year patches to maintain full funding.
Ms. Tavenner appears to have surmounted an obstacle that arose this month, after the political intelligence firm Height Securities issued an alert about a looming decision by the Obama administration to avoid rate cuts in the Medicare Advantage program. The alert was issued before officials went public with the decision and sent shares of health insurance companies, such as Humana Inc., soaring.
Sen. Chuck Grassley, Iowa Republican, raised questions about the leak, and Mrs. Tavenner promised to investigate.
In a letter to the senator Friday, she said lawyers at the Department of Health and Human Services have forwarded the inquiry to the agency's office of the inspector general.
"I am committed to ensuring that [the Centers for Medicare and Medicaid Services] safeguards confidential and nonpublic information," she said, "and intend to use the results of the [inspector general's] investigation to improve our processes where necessary."
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