Medicare Administrator Steps Down

It was pretty clear that controversial Medicare head Don Berwick wasn’t going to make it past the end of the year, after 42 Republican senators vowed to block his confirmation. On Wednesday, the Obama administration finally announced that Berwick will step down, a major scalp for Republicans in the health care battle, but one that will probably get lost in the Thanksgiving news blackout:

Obama nominated Berwick to the post but before Democrats scheduled a hearing, the president bypassed the Senate and appointed him to the post during recess last July, which allowed him to serve through the end of the year.

The White House has announced it will nominate Berwick’s deputy, Marilyn Tavenner as a replacement. The move actually comes as a surprise to many, who expected Obama to simply named Tavenner acting administrator in order to avoid a potential confirmation battle in the Senate:

“I can’t imagine a lot of support for her” among Senate Republicans, a Republican health lobbyist said. “That position always gets sucked into the controversy of the day — Part D, PPACA. That makes confirmation really hard.”

But Dan Mendelson, president of Avalere Health, said the nomination strategy suggests the administration must “think she’s got a decent chance of going through.” Without some indication of support from Republicans, “this is not a good strategy,” he said.

It is an interesting move from the White House, and probably not one that will please Senate Democrats. But Obama’s been campaigning against Republicans in Congress and might hope that a high-profile confirmation battle will end up energizing his political base, especially if it revolves around his signature health care law. And after all, there’s no downside for the president. Even if Tavenner’s confirmation is blocked, he can still appoint her as acting administrator. It would be yet another instance of Obama provoking divisiveness for the sake of politics instead of focusing on governing.