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Medicare Chief Reportedly Ready to Step Down

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Medicare Chief Reportedly Ready to Step Down

Politics

Medicare Chief Reportedly Ready to Step Down

Medicare Chief Reportedly Ready to Step Down

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There are reports that Mark McClellan, head of the nation's Medicare and Medicaid programs, will step down. He is likely to take up a post with a Washington think tank.

RENEE MONTAGNE, host:

The head of the Medicare and Medicaid program may be on his way out. News reports over the weekend said Mark McClellan is set to offer his resignation as early as today.

And if the name sounds familiar, Mark McClellan is the older brother of former White House Press Secretary Scott McClellan. He's been a key health policy maker throughout the Bush administration.

With us to discuss what this might mean is NPR's Julie Rovner. Good morning.

JULIE ROVNER: Good morning.

MONTAGNE: How big a role has Mark McClellan played in this administration's health policy?

ROVNER: Well, very big. I've often referred to him as the administration's utility infielder on health. He's actually had three different jobs.

The first two years he was at the White House as the top health policy adviser. He's a physician and an economist, and he helped develop the administration's proposal for tax credits for the uninsured, a proposal that hasn't gotten through Congress yet. In late 2002, when the administration was having trouble finding a candidate who could get approved by the Senate to head the Food and Drug Administration, they asked McClellan to step in and go over there, which he did. Then, in 2004, when the Medicare job came open at a particularly politically sensitive time, he was asked to move over there to oversee implementation of the brand new prescription drug benefit.

MONTAGNE: And he has something of a mixed record in that job, so is that the reason he's stepping down now?

ROVNER: Well, I don't think so. I think overall there have probably been more plusses than minuses at the Medicare agency. He certainly got a lot more companies to participate in the drug benefit than anybody had expected, and more seniors to sign up than people had predicted at lower premiums than anyone had predicted. But there have been a fair number of glitches, I guess which was to be expected with anything this large.

The most recent glitch came last month when about a quarter of a million beneficiaries got mistaken refunds worth an average of about $200. Refunds they're now going to have to figure out how to pay back.

Also, as many as seven million seniors could fall into this notorious gap in coverage in the benefit that's known as the doughnut hole, and that's going to happen right as the campaigns are heating up for the fall elections. There's some concern that that could play a role in some of these very close races, particularly for the House.

MONTAGNE: And another issue nagging at Mark McClellan has to do with his old job at the FDA.

ROVNER: Yes. He was at the FDA during the initial consideration of the request to sell the so-called morning after birth control over the counter. There's a lawsuit that's going on about that, a lawsuit that's still alive in spite of the FDA's action last week to approve it over the counter for those over 18.

In a deposition for that lawsuit, McClellan said that he was not involved in the decision in any way. But some senior scientists at FDA who were also deposed in that case said it was their impression that he was involved in that decision and in fact he had said that it would not be approved for those under 18 under any circumstances. And that's even before the scientific analysis had been done. So that case is going to go on even after he leaves.

MONTAGNE: So what is he expected to do next?

ROVNER: Well, he's expected to leave the administration for the first time. He can always go back to Stanford, where he's actually on leave as an associate professor of medicine and economics. But the rumors have long been that he's going to go to a Washington think-tank, which will be a pretty easy fit for him. He's a long published health policy researcher and he's expected to go back to that, at least for awhile.

MONTAGNE: Julie, thank you very much.

ROVNER: You're very welcome.

MONTAGNE: NPR's Julie Rovner.

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