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Obama introduces Kathleen Sebelius as Health secretary nominee

The president selects the Kansas governor for the senior health post in his Cabinet. Nancy-Ann DeParle is named to head the new White House Office of Health Reform.

March 03, 2009|Noam N. Levey

WASHINGTON — President Obama turned to a Washington insider and a Washington outsider Monday to lead his ambitious effort to reshape the nation's healthcare system.

The president asked former Clinton administration official Nancy-Ann DeParle to head the newly created White House Office for Health Reform, a job that will probably require extensive and delicate work with congressional lawmakers.

And he announced the nomination of Kansas Gov. Kathleen Sebelius to head the Department of Health and Human Services, tapping a popular red-state politician to become one of the leading public faces of his administration.

Sebelius would assume responsibility for the federal government's largest domestic department, a 65,000-employee behemoth charged with overseeing the severely strained Medicare and Medicaid programs and a host of other agencies, including the Food and Drug Administration.

Sebelius and DeParle know each other and are on friendly terms. "There won't be the usual turf fighting. . . . This will be an excellent working relationship, which is very good news for healthcare reform," said Donna Shalala, who introduced the two women when she served as secretary of Health and Human Services in the Clinton administration.

Sebelius and DeParle are to take jobs that Obama had hoped to give to former Senate Majority Leader Tom Daschle, who many had seen as uniquely qualified to advance Obama's healthcare agenda because of his experience as a lawmaker and his understanding of healthcare policy. The South Dakota Democrat withdrew his nomination last month over unpaid taxes.

As the president began his healthcare push last week with a budget that set aside more than $630 billion for the campaign, others in the administration were forced to take the lead.

On Monday, Obama said he would look to Sebelius to help bridge a partisan divide that already threatens the most aggressive effort to reshape healthcare since the Clinton administration's failed bid in the early 1990s.

"There's no easy formula for fixing our healthcare system," Obama said at the White House as he introduced his choices. "What is required, however, is a commitment to reform that focuses not on Democratic ideas or Republican ideas."

Telegenic and politically astute, Sebelius, 60, has spent nearly two decades working on healthcare issues while winning four statewide elections as a Democrat in an overwhelmingly Republican state. In 2006, she cruised to reelection as governor, winning 58% of the vote and raising a state-record $5.1 million.

As insurance commissioner in the late 1990s, Sebelius won praise from consumer advocates for blocking a bid by insurance giant Anthem Inc. to take over Blue Cross Blue Shield of Kansas, a move she argued would hurt policyholders.

Sebelius has also been an outspoken advocate of universal coverage, a major priority of Democrats in Washington. But as governor, many of her more ambitious efforts to expand government-funded healthcare were blocked by conservative Republicans who dominate the Kansas Legislature.

She lost a bid to raise tobacco taxes in 2004 to finance coverage for low-income Kansans. Last year, GOP lawmakers rejected a proposal to provide state subsidies to help uninsured people buy coverage.

"A lot of Kansans are violently self-reliant," said Rep. Melvin Neufeld, a former speaker of the Kansas House. "People don't think the government-run answers work real well."

Sebelius responded with more incremental steps, including the creation of the Kansas Health Policy Authority, a state agency to coordinate government healthcare services and chart a path toward broader change.

Marcia Nielsen, who heads the authority, said Sebelius focused on controlling costs and improving healthcare quality by such steps as creating incentives for state employees to quit smoking.

Sebelius is expected to win confirmation relatively easily, though opponents of abortion may campaign against the governor, who supports abortion rights.

Sebelius will be expected to help overhaul the FDA, which has been badly tarnished by recent outbreaks of food-borne illnesses and controversy over its pharmaceutical approval process. Also in Sebelius' department are the Centers for Disease Control and Prevention, the National Institutes of Health and the Indian Health Service.

Several veterans of healthcare politics said Sebelius would probably not play the central role in pushing Obama's healthcare agenda with congressional leaders. Committee chairmen on Capitol Hill are notoriously wary of outsiders who have never served in Congress.

"She has a huge department to run," said Shalala, president of the University of Miami. "The secretary's job is not to go to the Hill and negotiate on a day-to-day basis."

For Capitol Hill negotiations, Obama is turning to DeParle.

The Tennessee native and lawyer has an extensive policy background, having overseen healthcare issues in President Clinton's Office of Management and Budget. In the last three years of the Clinton administration, she oversaw Medicare and Medicaid.

In both capacities, DeParle worked extensively with congressional offices.

DeParle is also well acquainted with many industry leaders and has sat on the boards of major healthcare companies, including medical device maker Boston Scientific Corp.; Medco Health Solutions Inc., the nation's biggest manager of employee prescription drug benefits; and Cerner Corp., a health information technology firm.

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noam.levey@latimes.com

Andy Zajak of the Chicago Tribune contributed to this report.

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