Andrew Slavitt has been the "acting" administrator of CMS since March 2015. (Image: Senate Finance Committee/hearing)

The U.S. Department of Health and Human Services does actually have a genuine, confirmed secretary, Sylvia Mathews Burwell.

But the Centers for Medicare & Medicaid Services, the arm of HHS that runs HealthCare.gov, has had an acting administrator, Andrew Slavitt, since March 2015 — when dinosaurs roamed the earth and some big health insurers were still talking about how well their exchange plan programs were doing.

Now Donald Trump, the president-elect, is gearing up to have his own nominees put through the Senate confirmation wringer. 

Related: Treasury pick Mnuchin says tax cuts to double U.S. growth

I like the idea of constitutional checks and balances and would prefer to see them all stay in place.

A significant, energetic minority in the Senate probably should have the ability to block specific administration nominees who appear to be intent on eating baby seals for breakfast, or who turn out to have been running international drug cartels.

But I think the American people deserve for Republicans and Democrats to figure out an informal mechanism for ensuring that federal agencies can have “permanent,” confirmed managers, even in an age of morbid gridlock.

An idea: Any time senators block an administration agency nominee, they should have to provide a list of five alternative candidates who will have at least the grudging support of 10 senators from their side of the aisle.

To keep Democrats from offering a Trump administration a list of five people to the left of Bernie Sanders, and to keep Republicans from offering a list of five alternatives to the right of Genghis Khan, to a future Democratic administration, the custom should be that all five of the acceptable alternatives must come from the president’s own party. All five of the proposed candidates should have served as a governor, a U.S. senator or a mayor of a city with 10,000 people; served in a high-level position in the U.S. Government Accountability Office or the Congressional Budget Office; or have been an active, visible supporter of the president during the general election campaign.

That way, all of the proposed candidates would be solid people who are sympathetic to the president’s views and have faced some public scrutiny.

Maybe the president would reject even those five alternatives and stick by an unacceptable nominee who would serve as an “acting” agency head for years. But at least the president would have a fair chance to have a confirmed agency head, not face the risk of seeing one nomination after another fail.

Related:

On the Third Hand: Tavenner

Hawke Nomination On Hold

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