Obama Will Bypass Senate, Use Recess Appointment for Medicare Chief
Obama intends to use a so-called recess appointment to put Dr. Donald Berwick in charge of the Centers for Medicare and Medicaid Services, a White House official said Tuesday night. The appointment was expected Wednesday.
The decision means Berwick, an expert on patient care, can assume the post without being confirmed by the Senate, which is in recess for the July Fourth holiday. He could serve through next year without Senate confirmation.
Republicans had indicated they were prepared to oppose him over comments he had made on rationing of medical care and other matters. Democrats wanted to avoid a nasty confirmation fight that could reopen the health care debate. Berwick was nominated in April but no confirmation hearing had been scheduled.
"Many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points," White House communications director Dan Pfeiffer wrote in a post on the White House blog. "But with the agency facing new responsibilities to protect seniors' care under the Affordable Care Act, there's no time to waste with Washington game-playing."
The decision to use a recess appointment to skirt the Senate drew fire from Republicans even though the tool had been used frequently by presidents of both political parties. Obama last made a batch of recess appointments in March, and he was to make two other less prominent appointments Wednesday, one to a pension board and the other to a science post, the White House said.
"This recess appointment is an insult to the American people," Sen. John Barrasso, R-Wyo., said in a statement. "Dr. Berwick is a self-professed supporter of rationing health care and he won't even have to explain his views to the American people in a congressional hearing."
The Senate Republican leader, Sen. Mitch McConnell of Kentucky, said, "The fact that this administration won't allow the man charged with implementing the president's plan to cut $500 billion out of Medicare to testify about his plans for the care of our nation's seniors is truly outrageous."
Berwick, 63, is a pediatrician, Harvard University professor and leader of a health care nonprofit organization who's drawn support from many quarters, including the American Medical Association, since his nomination to oversee the enormous Medicare and Medicaid health insurance plans for the elderly, poor and disabled.
He's been criticized by Republicans for a number of comments, including telling an interviewer last year: "The decision is not whether or not we will ration care -- the decision is whether we will ration with our eyes open. And right now, we are doing it blindly."
Republicans have seized on that to cast Berwick as someone who would deny needed care based on cost, while supporters contend rationing already is done by insurance companies and Berwick simply wants transparency and accountability in medical decisions.
It's just those echoes of last year's acrimonious health care debate that Democrats would prefer not to replay on the Senate floor.
Medicare has been without an administrator since 2006, and the White House says the need to fill the post is critical because of its role in implementing the new health care law. Medicare is to be a key testing ground for numerous aspects of the new law, from developing new medical techniques to trying out new payment systems, and the White House says a permanent leader is key with deadlines approaching.
In addition to his professorship at Harvard, Berwick is the president of the Institute for Healthcare Improvement, a nonprofit in Cambridge, Mass., that works to develop and implement concepts for improving patient care.
Also being appointed Wednesday are:
--Philip E. Coyle III as associate director for national security and international affairs at the White House Office of Science and Technology Policy.
--Joshua Gotbaum as director of the Pension Benefit Guaranty Corporation.