WASHINGTON (AP) -- A former intensive care nurse with a businesslike approach to a politically divisive public policy area won Senate approval Wednesday to run Medicare and other major health insurance programs.
By an overwhelming 91-7 vote, the Senate confirmed Marilyn Tavenner to oversee Medicare, Medicaid, children's health insurance and coverage for the uninsured under President Barack Obama's health care overhaul.
Together, the programs under the Centers for Medicare and Medicaid Services cover more than 100 million Americans, ranging from newborns in low-income families, to people with severe physical and mental disabilities, to patients under hospice care in their last days of life. Part of the Health and Human Services Department, the agency has a budget of about $850 billion that easily eclipses spending on national defense.
Obama's health care overhaul will broaden the reach of Tavenner's agency as 25 million or more uninsured people gain coverage beginning next year.
Tavenner, 61, started out as a nurse at Johnston-Willis Hospital in Richmond, Va., working in demanding situations that called for a mix of strong clinical knowledge, steady nerves, and the ability to plan and execute in real time. From ICU nurse, she rose to emergency room supervisor.
Then her career took a turn as she decided to go into administration. She worked her way up to become the hospital's CEO, and eventually a top executive of its parent company, Hospital Corporation of America. She voluntarily removes herself from all decisions about the big hospital chain.
Tavenner switched tracks again, to government service this time, becoming Virginia's health secretary under former Democratic Gov. Tim Kaine. She joined the Obama administration early in 2010 as the health care law neared final passage in Congress following months of heated debate.
Her confirmation marks the first time in more than six years that the Medicare agency will have a Senate-approved leader. Senate confirmation is an important distinction for department heads and major agency chiefs in Washington, conferring a degree of status and permanence on the individual, but also signifying accountability to lawmakers of both parties.
Tavenner became acting administrator in December 2011 after Senate Republicans blocked the confirmation of her predecessor, Don Berwick. A pediatrician and nationally recognized health care innovator, Berwick ran into political trouble after Republicans said some of his statements as an academic smacked of support for socialized medicine and rationing, charges he repeatedly denied.
Such controversies have been absent from Tavenner's tenure. Early on, she won the public endorsement of Rep. Eric Cantor, R-Va., the second-ranking GOP lawmaker in the House and an influential conservative. Avoiding ideological battles, Tavenner has promised to focus on problem-solving in her management of the giant health care programs.
"This is a critical time to have someone with Ms. Tavenner's experience confirmed and in charge," Senate Finance Committee Chairman Max Baucus, D-Mont., said.
Her honeymoon may not last for long, however. Tavenner's main focus these days is to ensure a successful rollout of Obama's health care law. Senate Republican leader Mitch McConnell of Kentucky said he voted against the nomination for that very reason.
Republicans haven't stopped trying to sink what they deride as "Obamacare." The next repeal vote in the House could come Thursday.