A challenging year ahead for the new AHIP czar
“Running AHIP is one of the toughest jobs in D.C., period.”
– Former CMS official John Gorman
It’s especially tough when you’re new to the job, your most powerful members are defecting and you’re a former Obama administration official. Marilyn Tavenner, the former head of the CMS, faces all those challenges and more in 2016, a year when the biggest players in America’s Health Insurance Plans will be in the antitrust authorities’ crosshairs.
Her confirmation to head the CMS in 2013 by a Republican Congress showed she had allies on both sides of the aisle on Capitol Hill. But those ties will be severely tested in the coming year.
Critics now say AHIP’s hiring Tavenner so soon after she quit the CMS represented a conflict of interest. At the CMS, she was one of the ACA’s biggest backers.
Now, as AHIP’s chief executive, she has to spend her days talking to Republicans eager to replace a law that brought her members 10 million new customers. She will also have to defend the individual mandate—key to making the new exchanges work—while staving off demands for further cuts to Medicare Advantage.
She will also be under pressure to show results in reining in prescription drug price increases. While the topic has sparked congressional hearings and gained the attention of 2016 presidential candidates, Tavenner faces a drug industry lobby that’s demonstrated its ability to wield influence on the Hill.
In a blog post toward the end of 2015, Tavenner said she wants to focus on consumer empowerment through pricing transparency and quality comparison tools. She also advocated for more coordinated care.
But her tasks won’t be made easy by fissures emerging in AHIP’s membership. United HealthGroup, the nation’s largest insurer, quit the group weeks before she got her job. And Aetna, another top player, confirmed last week it would drop out.
Tavenner spent 25 years in various leadership positions at Nashville-based HCA before going to the CMS, which is usually considered one of the toughest jobs in healthcare. With trustbusters scrutinizing insurance mergers and a long list of legislative issues on her plate, 2016 may be her biggest challenge yet.
“This is no picnic,” said former CMS official John Gorman, who worked in the Clinton administration. “I think running AHIP is one of the toughest jobs in D.C., period.”
Marilyn Tavenner Position President and CEO
Organization America’s Health Insurance Plans
Tenure in job
Previous positions CMS administrator; LifePoint Health board of directors