Senator Looks to Delay Choice of Tavenner as CMS Administrator

Marilyn Tavenner to Lead Medicare, MedicaidNew Wrinkle in Tavenner Nominiation

On April 24, one day after the Senate Finance Committee voted to approve Marilyn Tavenner to be administrator of the Centers for Medicare and Medicaid Services (CMS), a new wrinkle developed. Senator Tom Harkin, (D-IA) has halted the nomination of Tavenner, saying at a budget hearing last Wednesday “he wants answers on why funding for wellness  is to be cut from the federal budget.”

Major news media also picked up the surprising twist.

From the Washington Post’s Sen. Harkin has a hold on Obama’s Medicare pick. What gives?:  Harkin is demanding, according to spokeswoman Katie Cyrul Frischmann, “An ongoing conversation about the future of the prevention fund.” That would be the health law’s Prevention and Public Health Fund, which initially was a $15 billion trust fund dedicated to supporting public health and prevention activities. Harkin has been the Prevention Fund’s main advocate since it was part of the health reform debate. While the fund’s appropriations dropped from $80 billion when it was initially proposed to $15 billion in the final version of Obamacare, that was still a significant commitment.

Modern Healthcare writes in Democratic senator blocks vote on Tavenner nomination: At the Senate Appropriations Labor, HHS Subcommittee hearing on Wednesday, Harkin blasted a proposal in President Barack Obama’s recently introduced fiscal 2014 budget to cut funding already allocated for an illness prevention fund.“However, I am greatly disappointed that the administration chose to help pay for the Affordable Care Act in fiscal year 2013 by raiding the Public Health and Prevention Fund,” Harkin said. “The Prevention Fund works. Thanks to this funding, more children are being immunized. More people are quitting smoking. More communities are fighting chronic disease. More people are being screened for hepatitis C. Robbing prevention when we know these efforts can improve people’s health and lower healthcare costs goes against the very mission of healthcare reform.”

Diana Manos at Healthcare IT News writes in Harkin holds Tavenner nomination hostage over wellness funding:  Particularly disturbing to Harkin is the proposed elimination of the Racial and Ethnic Approaches to Community Health (REACH) program, which Harkin calls “a staggering success.” The program was funded at $54 million in 2012, but has been cut completely from the proposed fiscal 2014 HHS budget. Harkin said he plans to propose another bill this year that would continue to allocate funding to the REACH program and other wellness programs. Sebelius told Harkin the Obama Administration is also concerned about prevention, but has chosen to put the funding into ensuring every American has access to a medical home and health insurance, which includes disease prevention education. Federal funding is also proposed to support other wellness movements, such as First Lady Michelle Obama’s obesity prevention program, and efforts to eliminate food deserts and tamp out tobacco use.