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Marilyn Tavenner moves from CMS to AHIP to “protect Medicare Advantage”

Head of Obama’s Health Care Rollout to Lobby for Insurers

By Robert Pear
The New York Times, July 15, 2015

Marilyn B. Tavenner, the former Obama administration official in charge of the rollout of HealthCare.gov, was chosen on Wednesday to be the top lobbyist for the nation’s health insurance industry.

Ms. Tavenner, who stepped down from her federal job in February, will become president and chief executive of America’s Health Insurance Plans, the trade group whose members include Aetna, Anthem, Humana, Kaiser Permanente and many Blue Cross and Blue Shield companies.

On Aug. 24, she will succeed Karen M. Ignagni, a former health policy specialist at the A.F.L.-C.I.O., who has led the industry’s lobbying arm for 22 years.

Most recently, Ms. Tavenner was the administrator of the Centers for Medicare and Medicaid Services, the federal agency that insures one in three Americans and has an annual budget of more than $800 billion. As administrator, she was in charge of HealthCare.gov.

Her selection as chief lobbyist for the industry highlights how federal health programs have become a priority for insurers, which increasingly depend on revenues from Medicare and Medicaid and the new public insurance marketplaces.

Asked about her priorities, Ms. Tavenner said she wanted to protect Medicare Advantage, the program under which private insurers manage care for more than 30 percent of the 55 million beneficiaries of Medicare.

http://www.nytimes.com/2015/07/16/us/ex-medicare-chief-marilyn-tavenner-...

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Obamacare Chief Nominee Pounded On Conflicts Of Interest

By Richard Pollock
The Daily Caller, July 12, 2015

Liberals and conservative have grave ethical concerns about Andy Slavitt, a former health care executive President Barack Obama nominated as his top administrator at the U.S. Centers for Medicare and Medicaid Services.

Of greatest concern to Congress is the apparent conflict of interest Slavitt poses as a top administrator at an agency that will set the rules for his old boss and the nation’s largest insurance company, United Health Group.

Slavitt has been acting CMS administrator since his former boss, Marilyn Tavenner, resigned earlier this year over repeated Obamacare failures.

CMS also is the largest single purchaser of health care in the United States, paying for almost one-third of the country’s health expenditures.

On the other hand, United Health Group is the largest health insurance company in revenues. It reported $122 million in operating revenues in 2013, about one-third which came from government coffers.

Then there are the profits United Health enjoys from CMS. The company sold insurance on many Obamacare’s state exchanges last year. United Health Group’s major profit centers also are based with Medicare and Medicaid. About 40 percent of the company’s operating revenue comes from administering Medicare and Medicaid.

http://dailycaller.com/2015/07/12/obamacare-chief-nominee-pounded-on-con...

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Comment:

By Don McCanne, MD

Although the Affordable Care Act included provisions to reduce the overpayment of private Medicare Advantage plans, each year HHS/CMS has used innovative measures to offset these reductions to ensure the viability of these plans. Now former CMS administrator Marilyn Tavenner has been selected to be president and CEO of the insurance lobbying organization, AHIP, the most influential outside organization during the health reform process. When asked about her priorities would be as head of AHIP, Ms. Tavenner said she "wanted to protect Medicare Advantage.”

Selected to replace her at CMS is Andy Slavitt, a former executive of United Health Group, the largest insurer in the nation, a dominant player in the market of private Medicare Advantage plans, not to mention being the provider of AARP Medigap plans and a major provider of administrative services for Medicare and Medicaid.

Karen Ignagni, AHIP’s previous president and CEO, essentially had carte blanche in the White House as ACA was being crafted. She also was very influential in obtaining the concessions that protected the excess payments to the Medicare Advantage plans, measures which greatly benefit United Health Group and others. It seems more than a coincidence that United Health Group dropped out of AHIP shortly after the resignation of Karen Ignagni.

So what is happening? Without insider information, it is very difficult to determine the degree of control held by each of the players, but there is no question that HHS/CMS, AHIP, and UnitedHealth and the other insurers are all participating in advancing the privatization of Medicare by enhancing the private Medicare Advantage plans with our taxpayer dollars. It is particularly disconcerting that this agenda is supported by Congress and the Obama administration.

Imagine what those excess funds could do for our traditional Medicare program, especially in reducing out-of-pocket expenses for premiums, deductibles, coinsurance and catastrophic losses. That would be far better than wasting them on the administrative excesses of the private insurers and on the dishonest activities they engage in to increase their profits by measures such as upcoding or gaming risk adjustment.

Why is there no public outcry? It is simply because the Medicare Advantage plans are able to use about one-third of the extra funds to reduce deductibles and coinsurance, making them appear to be superior products, plus there is no need to purchase supplemental Medigap plans. Most of the beneficiaries who are satisfied with their private plans would not be inclined to support increased taxpayer funding of the traditional Medicare program since it doesn't concern them anymore. And efforts to reduce Medicare Advantage funding to the same levels as traditional Medicare are met with loud protests orchestrated by AHIP. Those in the traditional Medicare program usually have supplemental retiree or Medigap plans with which they are satisfied, and thus they are not advocates for change either.

It is really difficult to explain to people that what is a good deal for them is a bad deal for all of us together since it perpetuates high costs and extraordinary administrative waste. If their programs seem to be working for them, they don't want change.

We need to improve the traditional Medicare program so that it is more comprehensive and provides greater value, and then use it to cover everyone. Our task is made much more difficult by the powerful forces that support corporate control of our health care system. After all, they are the ones with the money. And Tavenner and Slavitt will be there as their agents, working inside and outside of the government. And most people won't care.