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Marilyn Tavenner, head of Medicare and Medicaid resigns

“February will be my last month serving as the administrator for C.M.S.,” Tavenner said in an email sent to employees at the agency, The New York Times reports.

Tavenner, who was partially responsible for the mistake-laden debut of the online insurance exchange that started in October 2013 hadn’t given any public indications that she was planning to step down, the Times reports. In February 2010 she joined the administration a few weeks before President Obama signed the Affordable Care Act.

A woman reads the HealthCare.gov insurance marketplace internet website  where people can sign up to...

A woman reads the HealthCare.gov insurance marketplace internet website, where people can sign up to benefit from Obamacare, in Washington in December 2013
Karen Bleier, AFP/File

Tavenner was a senior official at the Medicare agency, which has an annual budget of over $800 billion and insures one out of every three Americans, before being confirmed by the Senate in May 2013 as administrator.

In a statement, Sylvia Mathews Burwell, the secretary of Health and Human Services, accepted the resignation and praised Tavenner.

“Marilyn will be remembered for her leadership in opening the health insurance marketplace,” Burwell said. “In so doing, she worked day and night so that millions of Americans could finally obtain the security and peace of mind of quality health insurance at a price they could afford.”

“It’s a measure of her tenacity and dedication that after the tough initial rollout of HealthCare.gov, she helped right the ship,” Burwell noted.

The exchange is a key part of the health law and as such lets people shop for health insurance policies, but for the first several weeks after it opened in the fall of 2013, it was nearly unusable, the Times reports.

In October of 2013 she faced a stiff grilling by House Republicans, CNN reported.

In her testimony, she told the House Ways and Means Committee that the “vast majority” of consumers would be able to use the site by the end of November.

And she did something that CNN reported wasn’t very typical in the Obama administration.

She apologized.

“I want to apologize to you that the website does not work as well as it should,” she said, and added that HealthCare.gov “can and will be fixed.”

This was definitely the hot seat for Tavenner, whose agency garnered a fair share of the blame for the troubled website and became a political ball-and-chain for President Obama and the healthcare reforms that he championed. It also served as a mechanism for the Republicans to vent their all-too-familiar bile about the new reforms that they failed to purge in such spectacular fashion.

The reason that Tavenner has decided to resign isn’t known yet, MedCity News reports. With such a stressful job and a new GOP Congress set to sink its teeth into Obamacare once again, it’s not entirely surprising that she wants to resign.

Tavenner’s former boss is Kathleen Sebelius, the health and human services. Sebelius resigned in April 2014, largely due to the tempestuous rollout of the ACA.

Rich Umbdenstock, President and CEO of the American Hospital Association praised Tavenner in a statement.

“As a nurse, health care executive and government official she brought a practical perspective to running a very complex government agency,” he said. “Her ability to work in a bipartisan manner with legislators and listen carefully to the concerns of hospitals and other stakeholders was key to her effectiveness as a leader. Combine them all together with her honesty, integrity and determination and you have a role model for public service.”

The politics of health care being what it is, may mean that it will be a challenge for President Obama to find a new Medicare chief who can win confirmation from the now largely Republican senate, the Times reports. The agency went for nearly seven years without a Senate-confirmed administrator before Tavenner was confirmed in 2013.

Senate majority leader Mitch McConnell (R-Ky) said he appreciated Tavenner’s hard work, but added “no one could have successfully managed a law as unworkable as Obamacare.” He added that the “sole focus”of the next administrator should be on Medicare and Medicaid, the Times reported.

As a nurse, Tavenner worked for over two decades at the Hospital Corporation of America, a commercial hospital chain. She was the secretary of health and human resources in Virginia, from 2006 to 2010, where she managed Medicaid and other programs.

When she was nominated for the top position at Medicare she was supported by Republican lawmakers, especially former House majority leader Eric Cantor of Virginia, per the Times.

In her farewell email, Tavenner highlighted accomplishments in many areas. She noted improvements in health care quality, especially managed-care plans for Medicare beneficiaries. She added that in addition, “in the past five years, we have seen historically low growth in overall health care spending,” and that the Medicare trust fund is assured to be solvent until 2030.

The health insurance marketplace “is a success,” she said, noting that 27 states were expanding eligibility for Medicaid, as Congress had intended in the Affordable Care Act, the Times reports.

Burwell said that Andrew M. Slavitt, who is the No. 2 official at the Centers for Medicare and Medicaid Services, will serve as the acting administrator.

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