Health Care

Who Is Nancy-Ann DeParle?

by Tim Foley

category: Obama And Congress

Published March 02, 2009 @ 12:42PM PT

While all the focus is on Kansas Gov. Kathleen Sebelius' appointment as Secretary-nominee for Health and Human Services, President Obama's second appointment of the day may have much more of an impact on getting his health care reform agenda passed.  Tom Daschle, Sebelius' predecessor, was set to be the point man on health care reform, but not from the HHS offices.  Instead, he would have a West Wing office as Director of the White House Office of Health Reform.  After speculation that Obama would jettison the office (and a post from me suggesting he should), he today appointed Nancy-Ann Min DeParle as the new Director of that office.  But this begs the obvious question - who is she?

Jonathan Cohn on The Treatment does a good job with her background and provides lots of revealing anecdotes on her personality and the seemingly genuine warmth people have for her, but I'm much more concerned with her mad skillz.  In the melee that will be the fight for health care reform, why should she get the ball?

1.) Knowledge of the subject matter?  Check.

The great quote from Cohn:  "DeParle is smart--rocket scientist, brain surgeon, 1600 SAT smart. And she knows as much about health policy as anybody you'll encounter in Washington."  How'd she get so smart?  She was the head of the Health Care Financing Administration - what we call today the Centers for Medicare and Medicaid, after first serving in the Clinton Administration as the Associate Director of Health & Personnel for the Office of Management and Budget.  Before then, she was the youngest Commissioner in Tennessee State Department of Human Services Ever.  Now, while serving on boards, she also teaches health policy as an Institute of Politics fellow at Harvard University.

Tom Daschle was well-regarded as a health care communicator and had a good grasp of the issues, but he relied on co-author Jeanne Lambrew to really go into the weeds.  DeParle will not need to.

2.) Knowledge of Congress?  Check.

Tom Daschle was considered the ideal pick because of his relationships in the Senate and the knowledge of its inner-workings.  He knew how to win a fight.  DeParle may not have Daschle's expertise, but she's also used to being in the thick of it with Congress.  During her tenure at HCFA, she had the tough task of implementing massive spending reforms to Medicare and Medicaid required by Balanced Budget Act of 1997 without crushing beneficiaries who relied on those services.  By all accounts, she threaded the needle very well.  It's also worth mentioning her tenure at HCFA overlaps with the original launch and implementation on SCHIP

She wrote a retrospective of her time at HCFA for Health Affairs magazine.  Tell me if this passage doesn't sound like useful on-the-job training for health care reform:

"I knew that to succeed I had to improve the agency's relationship with Congress. So I tried to build personal ties-traveling to a hospital in Muskogee, Oklahoma, with Rep. Tom Coburn; sampling barbecue with home health agencies and Rep. Joe Barton in Colleyville, Texas; meeting with seniors at a lunch in honor of Sen. John Breaux in Baton Rouge, Louisiana-and found that many members were willing to meet me halfway."

We should be so luck this time.

3.) Knowledge of the business community?  Check.

This is a trickier one, because you run into the same conflict-of-interest questions that began sprouting up about Daschle - did the work he did out of office, giving speeches to insurance companies and giving consultation to companies involved in the health care system constitute a conflict of interest?  (One of the weirdest things about the Daschle mess:  this concern only started being voiced loudly after his unrelated tax problems made news.)

Again, Jon Cohn notes people are asking this question of DeParle, but nothing has yet come to light.  She's a trustee for the Robert Wood Johnson Foundation, and sits on boards for Boston Scientific and Medco Health Solutions.  Cohn also notes, "MedPAC--the Medicare Payment and Advisory Council, a powerful government-chartered agency that advises Congress on what Medicare should cover and what it should pay."  But at the most, these constitute the possible opportunity for a conflict of interest - inconclusive, at worst.

But something that perhaps gets underestimated is the extent that the business community will need to be on board - or at least divided - to get health care reform passed.

So what doesn't she have?  Well, Daschle's star power as a public communicator, but that always seemed like a garnish rather than an essential for the role.  (Seen many in depth public presentations with Rahm Emmanuel lately?)  It's an open question how she'll fit into a White House structure with a lot of strong personalities - including Emmanuel, Sebelius, Orszag, Larry Summers and the president himself, all of whom have a clear stake in managing the health care reform process as well (and some of whom -- *cough* Larry Summers *cough* -- were rumored to be none too keen about Daschle's monopoly).  Still, one can't help but think she would be an excellent behind-the-scenes day-to-day legislative manager, which is exactly what the health care reform effort will need to compete with the head start by Sens. Baucus and Kennedy.

You're getting a lot of erroneous reports that Sebelius is the point person on health care reform (wassup, Reuters?)  No doubt, reforms to Medicare and Medicaid will be part of the process.  And honestly, Sebelius may well have a large role at the discussion table.  But the Office of Health Reform is an agency solely dedicated to getting this done in 2009.  DeParle sounds competent and more than a little impressive.