Just before the Thanksgiving holiday, Don Berwick, the administrator of the Centers for Medicare and Medicaid Services (CMS) announced his resignation. Consequently, President Obama has nominated Berwick’s top deputy, Marilyn Tavenner, as Berwick’s successor. Tavenner has an extensive health background as a nurse, a healthcare official at both the state and federal level and a hospital chain executive. In July 2010, when Obama found that GOP opponents were blocking the path to Senate confirmation, he installed Don Berwick as CMS administrator through a “pocket” appointment while the Senate was in recess. Unsurprisingly, Berwick is resigning because his confirmation as chief of the CMS was blocked by forty-two Senate Republicans, who say comments he made in the past criticizing the U.S. health system and complimenting the British National Health Service rendered him unfit for the job.

Although Berwick was administrator for only 18 months, he oversaw the rollout of crucial health reform regulations that stand to reshape both the private health insurance market and the Medicare program. Under his oversight, CMS drafted rules for the new health insurance exchanges, where Americans will be able to compare and buy health insurance plans online in 2014. Berwick also formulated rules for Accountable Care Organizations, a pilot program that is meant to move Medicare away from paying doctors for the volume of services they provide and toward reimbursements based on quality of care.

In the wake of Berwick’s resignation, President Obama is reminded that Congressional approval on both sides of the aisle is necessary for powerful appointments such as the chief of the Centers for Medicare and Medicaid Services (CMS). However, it should be noted that Berwick was running the CMS for almost two whole years without Senate confirmation, making major headway for Obama’s healthcare overhaul. Temporarily, President Obama found his way around Congressional Republicans to further the implementation of his Patient Protection and Affordable Care Act. Consequently, Obama’s attempts to bypass Congress are becoming evident and will further aggravate the disgruntled American people.

–Jordan Kinghorn