Obama Names Medicare Nominee To Key Health Care Post

FILE - In this Dec. 12, 2005 file photo, Marilyn Tavenner speaks in Richmond, Va. Medicare paid $5.6 billion to 2,600 pharmac
FILE - In this Dec. 12, 2005 file photo, Marilyn Tavenner speaks in Richmond, Va. Medicare paid $5.6 billion to 2,600 pharmacies with questionable billings, including a Kansas drugstore that submitted more than 1,000 prescriptions each for two patients in just one year, government investigators have found. The new report by the inspector general of the Health and Human Services department finds the corner drugstore is vulnerable to fraud, partly because Medicare does not require the private insurers that deliver prescription benefits to seniors to report suspicious billing patterns. (AP Photo/Steve Helber, File)

President Barack Obama nominated someone to run one of the biggest agencies in the federal government Thursday. It's not likely to matter, if recent history is any guide.

The agency is the Centers for Medicare and Medicaid Services and the nominee is Marilyn Tavenner. Being the administrator of the Centers for Medicare and Medicaid Services is a big deal: the agency has a massive budget, oversees Medicare, Medicaid and the Children's Health Insurance Program, and is in charge of implementing crucial parts of Obama's health care reform law.

So why might Tavenner's nomination not matter? For one thing, she basically already has the job: she's been running the place since December 2011 in an acting capacity.

More to the point, though, is the fact that the Senate hasn't bothered to vote on a Centers for Medicare and Medicaid Services nominee since Mark McClellan quit the job in October 2006 during President George W. Bush's second term.

Were Bush's and Obama's previous nominees grossly unqualified? Not really. But the Senate has become so dysfunctional the nominations are routinely help up or filibustered. If a veteran, nonpartisan federal budget official and a pediatrician and health policy expert weren't good enough for the Senate, why would Tavenner -- a nurse, former senior health official in Virginia and ex-hospital company executive -- fare any better?

This isn't even Obama's first attempt to get Tavenner confirmed. He nominated her back in November 2011, just before the resignation of the previous unconfirmed nominee, Donald Berwick. Tavenner never got so much as a Senate committee hearing.

For more background on why this important agency hasn't had a confirmed leader in more than six years and why that matters, read this post and this article from Politico.