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Administration Official Expresses Optimism for Health Care Overhaul this Year

By Drew Armstrong, CQ Staff

April 15, 2009 -- The Obama administration's head of its health care overhaul said Wednesday that she was optimistic it would become law this year.

"We're making a lot of progress in realizing the president's goal of getting health care reform enacted this year," said Nancy-Ann DeParle, the head of the White House's Office for Health Reform.

At a breakfast with reporters hosted by the Kaiser Family Foundation, DeParle painted a rosy picture of Democrats' work, saying that the divisions between lobby groups and any arguments in Congress were, so far, manageable.

"All the groups who were on different sides of the table 15 years ago are now at the same table, working together and talking about how we can reach these goals," DeParle said, specifically mentioning labor and business groups, as well as health care providers like hospitals. "No one wants the status quo. They don't start off talking about their position, they talk about how do we get everyone covered, how do we lower costs for businesses and families," she said.

DeParle said that in her first month on the job, she has met with around 40 members of Congress to discuss the administration's overhaul plans. Most of her time is spent meeting with members of Congress and their staff, she said, and she is also meeting extensively with the lobby groups.

Before taking the White House position, DeParle was administrator of what is now the Centers for Medicare and Medicaid Services in the Clinton administration. She also worked at the Office of Management and Budget. More recently, she worked for a private equity firm in New York, managing the firm's health care portfolio.

Introducing DeParle, Kaiser CEO and President Drew Altman held up a chart showing failed health care overhaul tries since 1950—from President Eisenhower's effort to President Clinton's failed try in 1993 and 1994. Altman half-jokingly warned DeParle that if the White House does not succeed in achieving a health care overhaul this time around, history would seem to dictate another 20-year wait before another attempt.

But at least in comparison to the Clinton attempt, DeParle said things were going well.

"Unlike the effort 15 years ago, Congress has put its money where its mouth is," DeParle said, referring to the legislature's decision to include a health care overhaul in its budget resolution and the efforts by key committee chairmen to get a head start on writing a bill.

And Congress does appear to be moving forward on schedule. On Tuesday, the Senate Finance Committee announced three "round tables" that will serve as informal committee hearings on health legislation.

An April 21 Finance Committee session will focus on reforming the delivery system, including how Medicare pays for services. A second session on May 5 will deal with expanding insurance coverage and access, and a final session on May 14 with deal with how to pay for an overhaul.

DeParle said that the efforts in the Senate, and statements by several key House committee chairmen that they would work together on the legislation, boded well.

"It's been, so far, a remarkably harmonious process," DeParle said.

DeParle said that she was making progress with lawmakers on one early issue that has emerged as a difficult point—whether or not to include a government-run insurance option as part of an overhaul. Republicans by and large oppose doing so, arguing that it will run private insurers out of business, while most Democrats support it.

"You have to sort of get the idea on the same page," DeParle said. "When you actually start talking about what it might look like, you realize you're talking about two different things," she said of her discussions with opponents of a public plan. Advocates of a public plan have increasingly talked about including safeguards to make sure such a plan would not compete with private insurers unfairly or simply dictate prices and take over the market.

She reiterated Obama's stance that an overhaul would have to be paid for over 10 years, but said the administration might have problems with any changes to the tax system—a cap on the employer exclusion for health care premiums, for example—that would have repercussions for people who already get health care coverage through their jobs.

DeParle said that Obama "has serious concerns about any kind of financing that's built on dealing with that tax exclusion or somehow undermining it. He's very skeptical of those plans and he's been clear about that."

Finance Committee Chairman Max Baucus, D-Mont., has several times mentioned using changes to the tax code—which could generate several hundred billion dollars by putting a cap on the tax exclusion for more expensive plans—to finance an overhaul.

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