Tom Daschle’s abrupt departure from President Obama’s inner circle is a blow to the new administration’s health reform efforts, but not a crippling one, healthcare insiders said Tuesday.
“It’s a cliché, but nobody is irreplaceable, even if somebody seems pretty close to it,” said Henry Aaron, an economist at the Brookings Institution. “This is not a torpedo below the waterline for the administration; it’s just an unfortunate occurrence,” Aaron said.
That outlook is shared by many inside the Beltway — along the ideological spectrum and at various interest groups.
“In every war, there’s always another general,” said Chip Kahn, president of the Federation of American Hospitals. “If the mission is important enough, then people will rally.”
Daschle, the former Senate majority leader who was in line to be secretary of Health and Human Services (HHS) and director of the White House Office of Health Reform, was part of Obama’s inner circle and had laid a significant amount of groundwork for the president’s ambitious health reform agenda.
Overall, the immediate assessment of activists and interest groups echoes the message coming from the White House: that health reform is coming, Daschle or not.
“The issue of affordable healthcare for every American is bigger than one person; and the job of ensuring healthcare reform will outlast any person nominated for the secretary of HHS and likely anybody that serves in this administration,” White House press secretary Robert Gibbs said.
“Sen. Daschle’s withdrawal could make the process harder, but it doesn’t change the urgency of reform,” said Nancy LeaMond, who is executive vice president of the seniors’ lobby AARP.
Insiders agreed that Obama must move quickly to nominate a new HHS secretary.
The president will have a difficult time finding someone who brings to the table the same extraordinary experience and understanding of Congress, politics and healthcare that Daschle possesses.
Obama has options, sources agreed.
During the presidential campaign and transition, other names were bandied about for HHS, particularly before Rahm Emanuel’s appointment as White House chief of staff took Daschle out of the running for that job.
Kansas Gov. Kathleen Sebelius (D) had been mentioned as a possible member of the Obama administration; some even speculated he might consider her as a running mate. Sebelius also has experience with healthcare policy as governor and as a former state insurance commissioner.
“There is no governor in the country who knows more about healthcare reform and regulation,” said Ron Pollack, the executive director of Families USA, a liberal advocacy group that is deeply involved in health reform. Pollack also said that Daschle’s decision to step aside isn’t a blow to healthcare reform.
Former Vermont Gov. Howard Dean, the recently departed Democratic National Committee chairman, is a medical doctor with considerable health policy experience. Dean remains a favorite of many on the political left but clashed repeatedly with Emanuel while the latter ran the Democratic Congressional Campaign Committee.
Tennessee Gov. Phil Bredesen and former Oregon Gov. John Kitzhaber have also been the subjects of speculation, as has former National Institutes of Health Director Harold Varmus.
Whoever the nominee is, he or she will assume the healthcare job with Congress and key interest groups already working on reform.
“I think the pieces for the most part are in place” for reform, said Mary Grealy, the president of the Healthcare Leadership Council, an industry group.
Indeed, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Senate Health, Education, Labor and Pensions Committee Chairman Edward Kennedy (D-Mass.) already are hard at work trying to craft health reform legislation and should not be expected to halt their efforts because of Daschle.
Healthcare interest groups, industry representatives and others who have been participating in the early-stage talks with Baucus and Kennedy also have a vested interest in keeping up their efforts.
Obama must decide, too, whether to grant his next HHS nominee the same unique role that Daschle was to have. Obama has centralized policymaking in his White House on a variety of issues, such as economics and the environment, leading to questions about what role Cabinet secretaries would play in his administration.
But Daschle secured special dispensation. Obama agreed to make him secretary and give him an office in the White House, which would have provided Daschle with extraordinary sway over the president’s health reform initiative.
“I really don’t think the fate of healthcare turned on Tom Daschle,” remarked Kaiser Family Foundation President Drew Altman. But, he added, “You do have to worry about a loss of momentum.”