It's pretty clear what they're really committed to

John O'Connor
John O'Connor

It was quite a week for ironic juxtaposition in the nation's capital.

On Monday, the White House rolled out what it called the most comprehensive nursing home regulations revision in a quarter century. All in the name of ensuring greater accountability, you understand.

Two days later, the former head of the Centers for Medicare & Medicaid Services (the agency that created and will enforce these pending rules), announced she'll soon be the insurance industry's top lobbyist.

Such a sudden about-face might raise eyebrows in most places. Then again, most places aren't Washington.

I'm not here to slam Marilyn B. Tavenner. Running CMS was and is no cakewalk. Among other things, the agency insures nearly a third of the nation's population and grinds through roughly $800 billion a year. It also decides which Medicare and Medicaid rules skilled operators must abide by. By all accounts, Tavenner was well-liked and did a pretty good job. Well, there was that little matter of the disastrous Healthcare.gov website rollout. But, hey, sometimes bad things happen to good people.

But what I do find a bit troubling here is the big picture. Tavenner now joins a long and growing list of people who have earned their bona fides as public servants, only to seek a K Street cashout afterwards.

The public-official-to-lobbyist-two-step is a legal and usually lucrative maneuver. But it's also rife with potential conflicts of interests. (Ever wonder how many current lawmakers keep their mouths shut about outrageous proposals that might benefit a possible future employer?)

As president and chief executive of America's Health Insurance Plans, Tavenner will be lobbying on behalf of many of the companies that will determine your managed care payments. Firms like Aetna, Anthem, Humana and Kaiser Permanente, just to name a few. She'll also be urging lawmakers to make the new rules for her clients as minimally invasive as possible. As Momma used to say, doesn't that make you think?

Not that she's the first to give the old revolving door a spin. Earlier this year, five former House members and a U.S. senator were on the payroll at lobbying firms less than one month after leaving office.

So there's plenty of precedent for the crossover. Still, it's unlikely that few of this year's newly minted lobbyists have had to swing so far, so fast. In fact, she might want to make sure her new employer's health plan covers whiplash.

John O'Connor is McKnight's Editorial Director.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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