Even though health care reform still hovers just below the radar, White House personnel are fully engaged in laying the groundwork for an expected summertime debate over some version of the overhaul President Barack Obama promoted during his campaign.
Much of the White House effort so far, according to sources on both ends of Pennsylvania Avenue, has been confined to a consultative role while Senators on the Finance and Health, Education, Labor and Pensions committees drive policy initiatives. White House officials generally do not attend Senator-level meetings held by members of the two panels.
The White House has been responding to specific ideas coming off Capitol Hill including providing technical assistance using the administrations vast research and number-crunching resources with its proactive efforts primarily in the form of overarching principles, such as those laid down by Obama during the campaign.
While numerous mid-level and senior staffers have been drawn into the effort, White House and Congressional sources say the embodiment of the effort is Nancy-Ann DeParle, Obamas health care czar who runs the Office of Health Reform. Under former President Bill Clinton, she supervised health issues in the Office of Management and Budget and from 1997 to 2000 ran the Health Care Financing Administration (now known as the Centers for Medicare & Medicaid Services).
She and her staff work out of a room in the Eisenhower Executive Office Building. Theyll operate in tandem with a Department of Health and Human Services office covering health reform that, with Secretary Kathleen Sebelius now confirmed, will be announced by the administration any day. The HHS office will be headed by Jeanne Lambrew, another veteran of the Clinton administration who served as deputy to the chief White House health care adviser. Lambrew, who co-authored a book on health reform with former Sen. Tom Daschle (D-S.D.), had been slated to serve as Daschles deputy at the White House before his candidacy to serve dually as HHS secretary and health czar collapsed earlier this year.
Others are also playing key roles, included White House Legislative Affairs Director Phil Schiliro. As legislative liaison, he would likely serve as a critical conduit to Capitol Hill no matter the issue, but Schiliros years as a top aide to House Energy and Commerce Chairman Henry Waxman (D-Calif.) give him a deep background in the intricacies of various health initiatives.
White House Chief of Staff Rahm Emanuel is also involved and is likely to take an increasing interest as the issue reaches an expected fever pitch this summer. National Economic Council Director Larry Summers is playing a role though he is also heavily involved in the Obama effort to rescue the economy and Sebelius is becoming a big player as she gets up to speed, having just been confirmed late last month.
The president, of course, is also involved, having spoken directly with HELP Chairman Edward Kennedy (D-Mass.) as well as Finance Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa), who both attended a private meeting with Obama last week.
Another senior Obama aide with his fingers already deep in the issue is OMB Director Peter Orszag, according to White House and Congressional officials.
Orszag, with his number-crunchers at the OMB, has the resources and background to perform some of the economic analysis demanded by lawmakers and their aides. During his preceding stint at the Congressional Budget Office, Orszag was an ardent proponent of the idea that the government must address health care costs in order to mitigate a long-term explosion in the governments financial obligations.
Orszag is a driving force behind the White House argument that health overhaul is necessary to drive down costs in Medicare, which is facing huge financial challenges as the nation ages. The strategy of selling health reform as a cost cutter is a critical component in the strategy to blunt arguments by Republicans that the price tag of Obamas health plans will be a huge drain on the budget, at the very least in the short term.
But it is DeParle who is firmly leading the effort, traveling to Capitol Hill nearly every day Congress is in session and meeting so far with more than 60 lawmakers from both parties.
She has a good reputation over here shes not new to the Hill, one Senate aide said. Shes familiar with Capitol Hill, and the Members are familiar with her.
DeParle, described by one White House colleague as a whirling dervish, is also conferring avidly with a panoply of health care stakeholders, including providers, insurers, pharmaceutical companies, patients rights advocates and business groups like the U.S. Chamber of Commerce and the National Federation of Independent Business.
In addition to her experience in health care, DeParle has also served as a director on corporate and nonprofit boards and as a managing director at a private equity firm, which may ease her relations with business interests some of whom are very concerned with the possible direction of the legislation.
Shes meeting with anybody whos got a good idea, said Linda Douglass, the administrations spokeswoman on health. Groups that opposed [health care reform] in the past are all eager to give us their opinions this time.
Vice President Joe Biden waits to conduct a mock swearing-in ceremony with Sen. Brian Schatz, D-Hawaii, in the Capitol's Old Senate Chamber, December 2, 2014. Schatz was sworn in to serve the remainder of his term since he was appointed to the seat after Sen. Daniel Inouye, D-Hawaii, passed away.