Who’s Who: Old Hands, New Faces and Some Surprises as the Health Reform Team Takes Shape in Washington

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The unexpected withdrawal of former Senator Tom Daschle as nominee for the twin roles of HHS Secretary and head of the new White House Office of Health Reform has left a major gap at the head of the Obama health care team, with rampant speculation on who and how to fill the void. Daschle’s rare combination of policy expertise, Washington know-how, deep congressional ties and a close personal bond with the president uniquely qualified him to steer the president’s ambitious reform agenda. With the failure of the Daschle nomination, many expect a more traditional model to emerge in which the HHS Secretary conducts the Department’s programs and day-to-day business, while a health reform “czar” housed in the White House focuses on shepherding a reform bill through Congress.

Despite the Daschle setback, the new president has been assembling a health care team notable for its extensive ties to Capitol Hill and experience with previous efforts to reform the health care system. Obama’s key health care appointments include:

White House. Jeanne Lambrew, a highly respected health care policy “wonk” and co-author of Daschle’s book on health reform, has been tapped as Deputy Director of the White House Office of Health Reform. Lambrew served in various health policy positions throughout the Clinton administration, at HHS, at the Office of Management and Budget (OMB) and in the White House, where she played a critical role in the design and enactment of the CHIP program. Peter Orszag, former director of the Congressional Budget Office (CBO), has been confirmed as Director of OMB, which will oversee Obama’s regulatory agenda and play a key role in designing a health reform plan. As head of CBO, Orszag had advocated for health reform as a means of addressing what he views as the single largest threat to the nation’s fiscal health - rising health care costs. And, not least, President Obama’s Chief of Staff, former Illinois Representative Rahm Emanuel (D), is also a veteran of the Clinton White House health reform efforts and a long-standing advocate of expanded coverage for children.
Department of Health and Human Services. Prior to Daschle’s withdrawal, two former Daschle staffers were named to key HHS positions. William (Bill) Corr, Daschle’s former Chief Counsel and HHS Chief of Staff under Secretary Donna Shalala, is awaiting Senate confirmation as Deputy Secretary. Mark Childress, another former Daschle aide, was named to be the Chief of Staff. Childress, along with several other HHS staff appointees with extensive Washington experience, has been working out of temporary HHS offices as they await the nomination and confirmation of a new Secretary. It is unclear how these appointments will fare under a change in leadership. And as of this writing, the administration has not named anyone to head the Centers for Medicare and Medicaid Services (CMS) or the Food and Drug Administration (FDA).

At the other end of Pennsylvania Avenue, there are many familiar faces at the helm of the key health care committees. In the Senate, Senators Max Baucus (D-MT) and Charles Grassley (R-IA) will continue to lead the Finance Committee as the Chair and Ranking Member. Senator Edward M. Kennedy (D-MA) remains at the helm of the Health, Education, Labor and Pensions (HELP) Committee with Senator Michael Enzi (R-WY) as Ranking Member. Senator Kennedy, whose presence will loom large over the health reform debate even during his absences from the Senate, has appointed a trio of HELP Committee members to spearhead working groups on various aspects of reform. Senator Barbara Mikulski (D-MD) will lead a task force on health care quality; Senator Tom Harkin (D-IA) will head a group focused on prevention and public health; and Senator Jeff Bingaman (D-NM) has been put in charge of health insurance coverage issues.

In the House, Representatives Henry Waxman (D-CA) unseated Representative John Dingell (D-MI) as Chairman of the House Energy & Commerce Committee, but has tasked the Michigan congressman to lead the Committee’s efforts to draft health reform legislation. Representative Joe Barton (R-TX) continues to serve as Ranking Member. The committee shares jurisdiction with the Ways and Means Committee over parts of Medicare, and has sole jurisdiction over Medicaid and most discretionary health care programs. The powerful Ways and Means Committee is presided over by Representative Charles Rangel (D-NY) with Congressman Pete Stark (D-CA) in charge of the Health Subcommittee. On the Republican side, Representatives Dave Camp (R-MI) and Wally Herger (R-CA) have assumed the ranking Republican positions for the full committee and health subcommittee, respectively. Ways and Means has jurisdiction over Medicare and tax issues.