I am heartened by the opposition of Senators Murkowski and Collins to the appointment of Betsy DeVos as Secretary of Education. I hope that signals more independence ahead. For me, personally, there is a bit of a back story.
In July, 2010, President Obama used his recess appointment authority to make me the administrator of the Centers for Medicare and Medicaid Services – CMS. That was not the original plan. When I was first asked to do that job, in 2008, shortly after the presidential election, the aim was a Senate confirmation. But with the polarized politics following that election and the intense maneuvering that led to the narrow passage of the Affordable Care Act, the administration judged it better to delay my formal nomination for almost a year and a half, until April, 2010.
By then, hope for my prompt confirmation was gone, and recess appointment was the only timely option the president had. CMS had had only Acting administrators for the previous six years, and, especially given its extensive role in implementing the ACA, leadership there had become an urgent priority.
The administration told me that it hoped for enough détente in the ensuing months to move my confirmation forward in the Senate. But that was not to be. In March, 2011, 42 senators, led by Senator Orrin Hatch, sent a letter to President Obama demanding that he withdraw my nomination. That letter was dripping with misinformation and completely ignored the extensive support for my nomination from a wide range of health care stakeholders, most of whom knew me far better than the signatories did. The president stuck by me. But, no matter; 60 Senate votes were required to beat a filibuster, and my confirmation was therefore dead. I served for the rest of my recess appointment term, which ended in December, 2011.
Leading CMS gave me the chance to contribute to the health and wellbeing of tens of millions of Americans and to launch a fleet of effective efforts to help make our health care system better. I felt lucky to serve, and sad to have to leave.
But, there is a sweet nuance to the story: five of the then 47 Republican senators did not join the 42 who signed the Hatch letter. Two are no longer in office: Scott Brown and Olympia Snow. But three are: Senator Susan Collins, Senator Lisa Murkowski, and Senator Rob Portman. Given the hermetic party discipline of that time, their dissent seemed remarkable. I did not know then, nor do I now, why they did not sign. Maybe they just missed the memo. Or maybe they were holding out for the due process and fair play of an open hearing. Or maybe they trusted the judgment of the American Hospital Association, the American Medical Association, AARP, and dozens of others who had praised my nomination.
I prefer to assume that their abstention was an act of courage and reason. That they were placing considered judgment above pure party loyalty. Some form of conscience and respect, I choose to believe, led these three to dissent from the party line. For that, I am grateful.
That small story deserves, at most, a footnote in the annals of political courage. In the big scheme, it didn’t really matter much. Many other Americans could have led CMS well.
But, in the era we are about to enter, courage of the same type, the courage to dissent in the interests of the public and the truth, will matter. It will matter monumentally. The Trump administration is showing recklessness terrifying to those who pray for the protection of the environment, peace, the poor, the ill, the dislocated. We face cabinet nominees publicly committed to destroying the agencies they would lead, health care legislation that would return tens of millions to the nightmare of medical bankruptcy, diplomatic and economic policies that would isolate our nation and renege on longstanding promises, and intemperance that could make even nuclear conflict more likely.
Senator Collins, Senator Murkowski, and Senator Portman, perhaps you did not want the role you now will play, but it is yours nonetheless. The Republicans hold 52 Senate seats in the new Congress. It will take only three of those votes to block unwise legislation. You are now one of the very few plausible bulwarks against irresponsible governing at the highest levels in our nation. I surely hope that more of your party colleagues would join when it counts, but let’s be clear: you are enough.
Once, with me, on a far smaller stage with far fewer consequences, you chose dignity, stewardship, and judgment – not the party line – as your guides. Thank you. Now, please, choose that course again, and stay that course, when the fate of so many people, nations, and even our planet will ride on your courage.
