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Senate Finance examines CMS nominee

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Republicans on the Senate Finance Committee praised Marilyn Tavenner as a human being today but were more skeptical about the policies she’s in charge of implementing.

The Senate Finance Committee held a hearing to review the Obama administration’s nomination of Tavenner to become the actual administrator of the Centers for Medicare & Medicaid Services (CMS).

Tavenner has been the acting director since 2011. She oversees Gary Cohen, the director of the Center for Consumer Information & Insurance Oversight (CCIIO), the agency that is directly responsible for organizing the Patient Protection and Affordable Care Act (PPACA) exchanges and handling other CMS PPACA implementation efforts.

House Majority Leader Eric Cantor, a Virginia Republican who worked with Tavenner she was in charge of Virginia’s Medicaid program, introduced her at the hearing.

Sen. Orrin Hatch, R-Utah, the highest-ranking Republican on the committee, put out a statement acknowledging that Tavenner has the qualifications to be the CMS director.

But, “if confirmed, you will have a daunting challenge ahead of you,” Hatch said in the statement. “In a speech last June, you said that the [new PPACA] health care exchanges ‘keep you up at night.’ I can relate. They keep me up at night, too, but probably not for all the same reasons.”

During the actual hearing, Hatch used a gentle tone with Tavenner, who was hoarse, but asked pointed questions about how Tavenner will try to make sure the exchanges — or Web-based health insurance supermarkets — actually work. 

Hatch noted, for example, that there are some predictions that lower-than-expected exchange enrollment growth could hurt revenue from the user fee that’s supposed to fund exchange operations.

“How much will the exchange user fees go up if enrollment targets are not met?” Hatch asked.

“That is a great question,” Tavenner said. She said she is using the Congressional Budget Office’s own enrollment projections and believes the number is appropriate.

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