WASHINGTON — Ten days before HealthCare.gov opened for business, Marilyn Tavenner, the relatively obscure federal bureaucrat whose agency oversaw the creation of the troubled online insurance marketplace, had a bad omen. It was a Sunday, and her mobile device was on the fritz, forcing her to go into the office.
“It reminded me that I can still be brought to my knees by a malfunctioning BlackBerry,” she joked in late September, recounting her technology woes to a group of insurance executives.
Nobody at the Centers for Medicare and Medicaid Services, the agency Tavenner runs, is joking now.
On Tuesday, she will be on Capitol Hill to face a grilling from House Republicans over the website’s failures. It will be an unusual turnabout for Tavenner, 62, who was confirmed overwhelmingly by the Senate in May on a bipartisan 91-7 vote and had the enthusiastic backing of the House Republican leader, Rep. Eric Cantor, who knows her from her days as health secretary in his home state, Virginia.
Her testimony, before the House Ways and Means Committee, will serve as a warm-up for that of her boss, Kathleen Sebelius, the health and human services secretary, who will appear before another House panel on Wednesday. Republicans, who have scheduled a series of hearings to examine the problems with the troubled website, have demanded that someone in the Obama administration be held accountable for the problem-plagued rollout.
“There’s a lot of fault to go around when it comes to the launch of the Obamacare exchanges, least of which is trying to figure out who was in charge,” said Sen. Orrin Hatch, R-Utah, who voted to confirm Tavenner. Referring to Tavenner’s agency and to the Health and Human Services Department, he added, “Was it CMS? Was it HHS? Was it the White House? That it’s this hard to unravel is unacceptable.”
While the Medicare and Medicaid agency has major responsibility for implementing the president’s health care overhaul, there have been hints that Tavenner was kept out of the loop on some critical decisions.
In July, after the Obama administration announced it was delaying the so-called employer mandate — a requirement that companies with more than 50 employees contribute to the cost of insurance or pay a penalty — Tavenner told lawmakers that she had been on vacation when the decision was announced and had no part in it.
“I was not consulted,” she said.
A onetime nurse and hospital executive, Tavenner came to Washington in 2010 to serve as deputy to Dr. Donald M. Berwick, President Barack Obama’s first, and controversial, pick to run the sprawling agency. After Berwick, who became a symbol of Republican discontent about Obama’s health policies, was unable to win Senate confirmation, Tavenner took over in an acting capacity in December 2011. Earlier this year, she became the agency’s first Senate-confirmed administrator since 2006.
Tavenner was not available for an interview Monday.
Republicans said they expected to press Tavenner on a range of issues, including how many people have signed up for insurance through the online exchanges and how hands-on she was in monitoring the development of the website and managing the various federal contractors on the project.
Rep. Dave Camp, R-Mich., the chairman of the Ways and Means Committee, said through a spokeswoman that he viewed Tavenner as “a serious witness” who would “shed light on the systemic failures that led up to the rollout.”
But Democrats expect Republicans to use Tavenner’s testimony mostly to lay the groundwork for tougher treatment of Sebelius, who some Republicans have said should resign.
“Clearly, the launch has had some substantial problems,” said Rep. Sander M. Levin of Michigan, the senior Democrat on the committee, “but I think the basic difference here is Democrats want to make it work and Republicans don’t.”
In recent days, press officers for Tavenner’s agency have been fending off questions about whether she foresaw problems and whether she notified Sebelius. On Monday, asked to describe the chain of command for work on the Affordable Care Act, a spokeswoman, Julie Bataille, said the agency took responsibility. “Our administrator has been in charge of our overall ACA implementation effort,” she said.
Tavenner may have to answer for the work of her subordinates: many decisions on the project were made by Michelle Snyder, the agency’s chief operating officer, and by Henry Chao, the head of the technology team. Contractors have said it was Chao who gave the last-minute order to require users to create accounts before they could shop for plans, a decision that contributed to a huge bottleneck before once the website went live.
Although it might seem there is little in Tavenner’s background that would prepare her to oversee the daunting task of building a website to serve millions of uninsured consumers, she does have considerable experience running complex organizations. This has, at least in the past, endeared her to Republicans like Cantor.
“She approaches problems of health care from the patients’ perspective,” Cantor told senators at Tavenner’s confirmation hearing, referring to her history as a nurse. “And given her long experience in the private sector, I have complete faith that she is an individual that will be able to take on the challenges that we face on behalf of the constituents that we represent.”