Big news: President Obama will nominate Kansas Governor Kathleen Sebelius to be the new Secretary for Health and Human Services. Here’s a photo from her gubernatorial website showing her comfort negotiating with the myriad of stakeholders in health reform:
For us in California, it is good that the head of HHS will have someone with considerable background in health policy, and in particular with a state’s role in health care. As insurance commissioner, she had the political backbone to stop a Anthem from taking over the state Blue Cross plan, a merger that was not going to benefit Kansas policyholders. She negotiated with a range of interest to win privacy protections for consumers, and worked for lower prescription drug prices. As Governor, she has run and prioritized the state’s Medicaid program even in a time of cuts, and sought to raise revenues to expand coverage to more children.
As her experience shows, states have a big role in health policy, from regulating insurers to running their Medicaid programs. Even though Kansas and California are different, it is good to have a prominent voice in the federal health reform debate to have first-hand knowledge about the experience, jurisdiction, and challenges of states and their role in health care.
There are parts of health reform that can best be done at the federal level, but any federal reform will need to be partially implemented at the state level. At the same time, state health reforms are best done when we have a partner, rather than an obstacle, in the federal government. For example, California is starting the process of renegotiating our Medicaid hospital financing waiver, and negotiating with a Secretary Sebelius is a much better choice than some of the other options considered.
In any time, HHS is a huge job: it has 65,000 employees and is the largest department outside of Defense. But in this crucial moment, the nomination of Secretary-designate Sebelius is good for the prospects for both federal and state reform.
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