Skip to main content

Advanced Search

Advanced Search

Current Filters

Filter your query

Publication Types



Newsletter Article


Obama Will Seek Health Care Overhaul Through Regular Order

By Alex Wayne, CQ Staff

JANUARY 8, 2008 -- Tom Daschle, President-elect Barack Obama's nominee to run the Department of Health and Human Services, promised Republicans Thursday that the new administration will not try to ram a health care overhaul through Congress under expedited budget procedures.

Daschle, a former Senate Democratic leader from South Dakota, faced no hostile questions during a hearing on his nomination before the Health, Education, Labor and Pensions Committee. He had clearly done spade work with Republicans beforehand; several mentioned that they had spoken privately with Daschle in recent days and enjoyed the conversations, which focused on health policy. One Republican, Orrin G. Hatch of Utah, said upfront that he would support Daschle's confirmation, indicating that the eventual Senate vote is a fait accompli.

The hearing's only real drama arose when the committee's senior Republican, Michael B. Enzi of Wyoming, asked Daschle if he "would discourage" the Senate from using a process called "budget reconciliation" to pass a health reform plan. "Yes," Daschle replied.

Reconciliation is an expedited procedure that bars filibusters and requires only a simply majority to pass legislation.

The exchange was polite, and only experts on congressional procedure who had also read a book Daschle published earlier this year on health reform likely grasped the tension behind Enzi's question.

In his book, called "Critical," Daschle suggested that Congress should consider addressing a health care overhaul in its annual budget resolution in order to speed its passage through the Senate. But that would effectively limit Republican input, because majority Democrats could push the bill through without support from GOP senators.

Obama has repeatedly said he wants to involve Republicans in drafting major legislation and to operate in a more bipartisan fashion than has been the norm in recent years.

"Our goal, our hope, our desire, is to use — as you referred to it — the 'regular order,'" Daschle said, meaning the traditional route for legislation, which entails consideration by subcommittees and committees and amendments on the Senate floor. "I'm determined to use regular order to produce the best product we can."

No Tough Questions

Daschle is a familiar figure on Capitol Hill. He served four terms in the House and three in the Senate before losing his seat in 2004 to Republican John Thune.

Republicans did not ask Daschle any questions about his personal qualifications for the job or issues that might present a conflict of interest, such as his work since leaving the Senate in 2005 for a Washington lobbying firm. Daschle was not a registered lobbyist for the firm, Alston & Bird, but the company lobbies Congress and HHS on behalf of many different health companies.

It is not clear if Daschle worked with any of those companies. Obama has said that people who join his administration from lobbying firms will not be allowed to work on issues that were the subject of their lobbying work. Spokespeople for Obama's incoming administration have said Daschle will recuse himself from working on such subjects when appropriate.

Republicans also did not ask Daschle about the work of his wife, Linda Daschle, an aviation expert and formerly a registered lobbyist who has focused on transportation issues. She sat behind Daschle at the hearing, along with his children and their spouses.

Obama also has named Daschle to lead a new White House Office of Health Reform; together with his position in charge of HHS, Daschle is indisputably Obama's point man on health policy.

"If confirmed, I will use these dual roles to marshal the talent and energy necessary to at last succeed in making health care affordable and accessible for all Americans," Daschle said.

In his book, Daschle proposed expanding Medicaid, the State Children's Health Insurance Program and Medicare to cover more Americans who are poor, old or young, while opening the Federal Employee Health Benefits Program — which provides private health insurance to federal employees and members of Congress — to everyone in the country. He also proposed a new "Federal Health Board" that would set policy on the technical aspects of health care and insurance coverage, relieving Congress of politically sensitive decisions that Daschle believes are best left to health experts and economists.

Many Republicans are concerned about a big expansion of government-run health care programs under Obama, but those concerns weren't especially evident on Thursday.

Sen. Tom Coburn, R-Okla., whom Daschle spoke with privately Wednesday evening, is considered one of the most conservative Republicans in Congress and doubtless will be a major obstacle to Obama's health reform plans. But his questions Thursday focused on whether Daschle would adopt good-government practices at HHS, such as reporting contracts to Congress and reviewing HHS programs for waste and inefficiency. Daschle promised that he would.

Democrats spent much of their allotted time asking Daschle if he would support their favorite health causes; in every case, Daschle promised that he would. Sen. Barbara A. Mikulski, D-Md., whose constituents include many HHS employees, asked Daschle if he would end what she sees as the politicization of HHS science agencies, such as the National Institutes of Health and the FDA.

"I want to reinstate a science-driven environment," Daschle said.

Sen. Bernard Sanders, I-Vt., asked Daschle if he would support a huge expansion of community health centers, which provide care to many people without insurance or with little access to doctors. Did Daschle agree that quadrupling the number of health centers, currently at about 1,100, would save money by diverting people from emergency rooms and reducing the need for hospitalizations? Sanders asked.

"No question," Daschle said.

The committee did not vote on Daschle's nomination. The Finance Committee, which oversees Medicare, has jurisdiction over his appointment and will hold its own confirmation hearing and vote to advance his nomination to the full Senate. No date has been set for the Finance hearing.

Publication Details