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Obama Names New Health Care Team to Tackle Reform Agenda

March 2, 2009 at 6:30 PM EDT
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President Barack Obama has named Kansas Gov. Kathleen Sebelius to head the Health and Human Services Agency and Nancy-Ann DeParle, a former Clinton official, to head the White House Office for Health Reform. Analysts examine the picks and the job ahead.
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JIM LEHRER: Next tonight, the president’s new health care team. Health correspondent Betty Ann Bowser begins our report.

BETTY ANN BOWSER, NewsHour correspondent: For the second time in less than a week, President Obama emphasized how high a priority health care reform will be on his agenda.

U.S. PRESIDENT BARACK OBAMA: If we’re going to help families, save businesses, and improve the long-term economic health of our nation, we must realize that fixing what’s wrong with our health care system is no longer just a moral imperative, but a fiscal imperative.

Health care reform that reduces costs while expanding coverage is no longer just a dream we hope to achieve. It’s a necessity we have to achieve.

BETTY ANN BOWSER: Kansas Gov. Kathleen Sebelius is the president’s second nominee as secretary of health and human services.

Former Senate Majority Leader Tom Daschle withdrew after admitting he had tax problems.

If confirmed, the 60-year-old Sebelius will take on an agency with Herculean responsibilities, everything from Medicare and Medicaid to food and drug safety to the National Institutes of Health.

President Obama, who last week proposed setting aside more than $630 billion in new health care spending over the next 10 years, said today that the Democratic two-term governor and former state insurance commissioner is up to the challenges ahead.

BARACK OBAMA: She’s won praise for her expertise from stakeholders across the spectrum, from consumer groups to insurers.

Over eight years as state insurance commissioner, she refused campaign contributions from insurance companies and protected the people of Kansas from increases to their premiums by blocking a takeover of the state’s largest insurer.

She helped draft a proposed national bill of rights for patients and served as the president of the National Association of Insurance Commissioners. And as a governor, she’s been on the front lines of our health care crisis.

She has a deep knowledge of what the burden of crushing costs does to our families and businesses. That’s why she fought to guarantee Kansans access to quality, affordable health care and sought to secure it for every Kansas child from birth to age 5.

BETTY ANN BOWSER: An early Obama backer, Sebelius was on the campaign trail and gave a speech at the Democratic National Convention in Denver last summer. Sebelius is a Roman Catholic who supports abortion rights, a position for which she’s been criticized by her local archbishop.

She also comes from political stock in the Midwest. Her father served as both a congressman and governor of Ohio. Her father-in-law, a Republican, is a former congressman from Kansas.

GOV. KATHLEEN SEBELIUS, D-Kan., Health and Human Services secretary-designate: I share your belief that we can’t fix the economy without fixing health care. The work won’t be easy, but bringing about real change rarely is.

Business and labor leaders, teachers and health care providers, policymakers at the state, local, and national level, parents and children are ready to join this effort. This isn’t a partisan challenge; it’s an American challenge and one that we can’t afford to ignore.

BETTY ANN BOWSER: To work hand in hand with Sebelius, the president chose Nancy-Ann DeParle as director of the new White House Office of Health Reform.

BARACK OBAMA: As commissioner of the Department of Human Services in Tennessee, she saw firsthand our health care system’s impact on workers and families. In the Clinton administration, she handled budget matters for federal health care programs and took on the tremendous task of managing Medicare and Medicaid.

BETTY ANN BOWSER: President Obama introduced his health care team just days before he convenes a White House summit on health care later this week.

Representatives from the health insurance industry, drug companies, consumers, and lawmakers from both parties are expected to attend.

JIM LEHRER: Judy Woodruff takes it from there.

Sebelius took on insurance industry

Burdett Loomis
University of Kansas
I think over all, as an administrator, she did a lot of smallish things. Overall, I think that you'd have to say that she would be somewhat disappointed in her overall impact.

JUDY WOODRUFF: Given the considerable political obstacles ahead, what kind of experience and limitations does the president's new team bring to the table?

We get the views of two who have worked with both appointees. Burdett Loomis is a professor of political science at the University of Kansas. He worked in Governor Sebelius' office in 2005.

And Len Nichols is director of the Health Policy Program at the New America Foundation. He served as senior adviser for health policy at the Office of Management and Budget in the Clinton White House, where Nancy-Ann DeParle was his supervisor.

Gentlemen, thank you both for being with us.

And, Professor Loomis, I'm going to start with you in Kansas. What were the main things that Governor Sebelius has tried to do there with regard to health care?

BURDETT LOOMIS, University of Kansas: Well, I think that she's definitely tried to expanded health care, increase quality, and keep costs down as a governor has to do in dealing in a balance budget situation.

She was working with the Republican legislature for the most part. And, honestly, many of her initiatives, such as expanding SCHIP or getting increased cigarette taxes, didn't come to fruition, I think in large part because of partisan opposition.

JUDY WOODRUFF: So, on balance, how well would you say she succeeded?

BURDETT LOOMIS: I think over all, as an administrator, she did a lot of smallish things. Overall, I think that you'd have to say that she would be somewhat disappointed in her overall impact.

And I think that's one of the things that has led her to take the HHS job, that this is a great opportunity to operate on a larger scale to make some successes where she's had less success in Kansas.

JUDY WOODRUFF: She was described, at least what I was reading today, as someone who took on the insurance industry. Is that how you'd characterize it?

BURDETT LOOMIS: As insurance commissioner, absolutely. And in particular, she took on the Anthem corporation, which wanted to buy out Blue Cross Blue Shield. And she was very tough on that. And I think it demonstrated her ability to combine politics and policy in a very convincing way. And that's one of her great strengths.

JUDY WOODRUFF: And you mentioned your state of Kansas is a Republican-leaning state, the state legislature majority Republican. She didn't have necessarily all successes, but how well did she work with Republicans?

BURDETT LOOMIS: I think she worked as well as she could, and particularly when she had the chance to have some leverage, in particular on a big school finance project, where the courts ordered much more spending. I think she worked very effectively with moderate Republicans to forge a really substantial change in school finance.

DeParle worked under Clinton

Len Nichols
New America Foundation
Nancy-Ann (DeParle) brings a wealth of experience in Washington. In some ways, she complements Governor Sebelius almost perfectly.

JUDY WOODRUFF: Well, Len Nichols, let's bring it to Washington now, where Governor Sebelius is going to be coming, but I want to also ask you about Nancy-Ann DeParle. You did work with her in the Clinton administration. What does she bring to be table?

LEN NICHOLS, New America Foundation: Well, you know, Nancy-Ann brings a wealth of experience in Washington. In some ways, she complements Governor Sebelius almost perfectly.

Governor Sebelius comes with having ran a state, having really been in charge of a Medicaid program, with having worked with the legislature on some tough issues, but also creating some administrative apparatuses that are probably going to serve Kansas well as they move forward, but she doesn't have Washington experience.

Nancy-Ann DeParle, on the other hand, as you heard in your opening segment, was at OMB under Clinton, ran Medicaid in Tennessee, but more importantly for the current struggle ran Medicare and Medicaid for the Clinton administration.

She oversaw the implementation of the Balanced Budget Act, with had profound implications for the Medicare program and I think it's fair to say, across the aisle and among stakeholders and consumers, earned a lot of respect for the hard work she did. So she brings a Washington insider view that complements Governor Sebelius' administrative and political experience.

JUDY WOODRUFF: And we know, of course, Medicare is going to be a big part of the battle over reforming health care.

LEN NICHOLS: You know, one of the amazing things, Judy, is how a number of commentators have come to see the vision that I think was first articulated by Peter Orszag when he was then chairman of the Congressional Budget Office. Health care reform is Medicare reform; Medicare reform is health care reform. You can't do them separately. You must do them together. And that means bringing all that experience together is the only way to solve the problem.

Working with Congress

Burdett Loomis
University of Kansas
I do think that pretty clearly the rough waters will come with anti-abortion activists.

JUDY WOODRUFF: So how do you -- do you have a sense, Len Nichols, of how the two will divide this up? Because, as we know, originally, President Obama's choice was Tom Daschle, and he was going to have both of these jobs, running Health and Human Services and holding this White House office.

Do you have a sense of how these two, Kathleen Sebelius and Nancy-Ann DeParle, are going to divide it up? Or do we just wait and see?

LEN NICHOLS: Well, since they've been nominated for about an hour-and-a-half together, I think I won't speculate too much. But I think you can look naturally at what the department does.

What the department does, it's a multiplicitous place, but it essentially has a number of fingers in our health care system in lots of different ways. So what the secretary will bring to any table about policy discussion, whether it be in the White House or on the Hill, is knowledge, deep knowledge, not only from own experience as governor of Kansas, but what she will know and learn as sitting atop the department for Medicare, the department for health and quality, the department -- the NIH and so forth.

Nancy-Ann DeParle, on the other hand, brings a Washington insider's view of how Congress works and maybe how to talk to Congress and how to work with Congress.

As you know, the president in his budget very clearly laid out I would call it both a carrot and a challenge. He said, "Come work with me to make this health reform work." Nancy-Ann, just like I know from the past, you have to work better with Congress than we did in '93-'94.

So I think she will bring fundamentally an awareness of how to do that. So I see them, again, as complementary, not contradictory.

JUDY WOODRUFF: Professor Loomis, let me come back to you. The only one of the two who's going to face confirmation hearings is Governor Sebelius. Any sense of what the tough part of that is going to be for her? Do you expect her to sail through? I know this is just a few hours old, but what's your sense of it?

BURDETT LOOMIS: My sense is she will do well and probably will get through pretty easily. I think it was a great indicator that both Sen. Pat Roberts, Sen. Sam Brownback, two relatively conservative, maybe very conservative Republicans, came out with an extremely positive statement about her candidacy.

I do think that pretty clearly the rough waters will come with anti-abortion activists. And she has had a series of confrontations in the state focusing third-term abortions and has had lots of opposition both from groups, but particularly in the state from the Catholic Church. And she is a Catholic.

Health care reform

Len Nichols
New America Foundation
But I do think this will be in some way the opening salvo of the debate about health care reform.

JUDY WOODRUFF: And what's the -- how would you describe her relationship right now with the church and with the strong anti-abortion groups?

BURDETT LOOMIS: Yes, I think they -- the groups is pretty straightforward. They oppose her on her policies. And she would like to have abortions be as rare as possible, but as a policy, I think she supports the Obama position, certainly supports Roe v. Wade.

I think with the Catholic Church, I think it's been personally very difficult for her. As an observant Catholic, she has come in for some harsh criticism from the archbishop. And I think that's been difficult on a personal level.

So at the same time, she's been steadfast. And women's groups support her strongly. And, you know, she's a tough cookie. And she'll get through this.

JUDY WOODRUFF: Len Nichols, how do you see this confirmation battle or process from the Washington perspective?

LEN NICHOLS: Well, I certainly agree with Professor Loomis. I expect Governor Sebelius to sail through, as these things go.

But I do think this will be in some way the opening salvo of the debate about health care reform. The president clearly has made it a priority, with having a summit this Thursday. But in some ways, her confirmation hearing may lead to some of the questions that are going to be part of our dialogue on this show and throughout the nation over the next 6 to 18 months.

And I think you can expect those things to come up. And they will be things like, what should be the role of the federal government versus the state? Again, a governor is very well-positioned to talk about how you may want federal rules, but you may want state flexibility. What should be the role of Medicaid? What's the role of private insurance?

JUDY WOODRUFF: And very quickly, finally, Len Nichols, her closeness to President Obama -- she's not as close to him as Tom Daschle was, is, but how important will that be in trying to do this job?

LEN NICHOLS: Well, there's no question, if you're going to try to change the health care system of our nation, you are going to need to have the full faith and confidence of the president of the United States when you go to speak for him in front of the members of Congress who will really make these decisions, as well as in front of the American people, as well as in front of stakeholders.

So I think having his full faith and confidence is extremely important. He clearly manifested that today. I know she was an early supporter of his, so I would assume and very much expect that she has that confidence or she wouldn't be in front of us today.

JUDY WOODRUFF: Len Nichols with the New America Foundation, thank you.

And, Professor Burdett Loomis, we thank you. We appreciate it.

BURDETT LOOMIS: Thanks, Judy.

LEN NICHOLS: Thank you, Judy.