Medicare chief Marilyn Tavenner pauses while testifying on Capitol Hill in Washington, Tuesday, Nov. 5, 2013, before the Senate Health, Education, Labor, and Pensions Committee hearing as the panel seeks reassurances about problems with the debut of the Affordable Care Act. Republicans on the committee emphasized their longstanding criticism of the law, citing examples of cancellations and increased costs while raising questions about cyber-security for healthcare.gov. (AP Photo/J. Scott Applewhite)