The New Republic

When President Obama introduced Kathleen Sebelius as his nominee to be Secretary of Health and Human Services a few moments ago, he also introduced Nancy-Ann Min DeParle as his new White House health care advisor.

You're going to hear a lot of talk about how important Sebelius is to Obama's plans for comprehensive health care reform--and, undoubtedly, she'll play an important role, particularly if and when it comes time to implement a reform scheme.

But when it comes to crafting a reform plan and then enacting it, DeParle's role is likely to be even more important. And that has advocates and health care experts very enthusiastic, although a few did express one key worry.

First, some biographical background: DeParle is famously reluctant to make an issue out of her upbringing, but friends and colleauges are quick to note that she cares about people facing economic struggle because, as the child of Chinese immigrants in Tennessee, she experienced that life herself. She ended up attending the University of Tennesse, graduating at the top of her class, and winning a Rhodes Scholarship, giving her a degree from Oxford to go along with the one she'd get from Harvard Law School.

DeParle eventually took over the management of Tennessee's Medicaid program under then-Governor Ned McWherter, making her (apparenlty) the youngest person ever to head a state Medicaid agency. In 1994, Time included DeParle on its list of "America's 50 Most Promising Leaders Age 40 and Under." Her record in Tennessee got the attention of the Clinton Administration, which recruited her to run the health team for the Office of Management and Budget. They later promoted her to run the Health Care Financing Administration, the agency that manages Medicare and Medicaid. (Today it's called the Center for Medicare and Medicaid Services.)

As you may have guessed from this sketch, 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. (I can attest to this personally, having interviewed her a few times.)

But DeParle also gets high marks for her political sense. She knows her way around Washington and, by all accounts, should be able to integrate herself within the White House policy operation easily. "She will complement Gov. Sebelius well, though her experience at the White House, with [HCFA], and on the Hill," says Chris Jennings, who served as chief White House health policy advisor during the latter years of the Clinton Administration. "And she will do so as a team player."

Despite her career-long identification with Democrats, DeParle has credibility with Republicans. (Representative Bill Thomas, of all people, was known to be a fan.) And, no less important for Obama, she's popular with centrist Democrats who could--if they wanted--make health care reform difficult. “Nancy-Ann DeParle has years of experience overseeing complex health care systems at both the state and federal level, and she knows firsthand the problems Americans face trying to get coverage," says Representative Jim Cooper, the Tennesse Democrat. "Nancy-Ann will be a great asset to the President as he leads the effort to reform health care." 

All of this would seem to make her an strong candidate for taking over Daschle's White House role, since it was a similar combination of skills--knowledge of health policy, political experience, and credibility on Capitol Hill--that made him so appealing for that job in the first place. But the possibility of other parallels with Daschle had some health care advocates just a bit unsettled over the past week, as her name was in circulation.

Since leaving the Clinton Administration, DeParle has worked as an investment advisor specializing in health care and is currently a managing director of CCMP Capital. She's also served on the board of health care companies, such as Boston Scientific and MedCo. DeParle, who is married to New York Times reporter and author Jason DeParle, has made a lot of money in her work--enough to buy a toney home that drew the attention of Washingtonian magazine.

Given the trouble Daschle had, because of his ties to the health care industry and fact that he profited mightily from it, could DeParle face similar scrutiny? During this time, DeParle served on 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. Did she take positions that would have benefitted companies on which she served, at the expense of the public good?

But these concerns were always expressed to me as questions--not accusations. In my admittedly limited digging, I found no examples of worrisome behavior. And one assumes the White House checked her private sector career a lot more carefully than I did. If their vetting had turned up anything even remotely disqualifying, it seems unilkely that they would be tapping her today.

(It surely helps that, as a White House advisor only, she won't have to go through the grueling Senate confirmation process. Remember, Daschle was up for HHS Secretary, too.)

This much I can say for sure: Within the health care community, people who either know DeParle personally or are familiar with her work are vouching for integrity--and doing so strongly. Typical was a statement Ron Pollack, president of FamiliesUSA, made to me last week: "She's an honest person who will serve health care reform well and won't be swayed by other associations she had in her private-sector business work."

As to the broader issue of whether DeParle is sufficiently committed to an agenda of making health insurance available to--and affordable for--everybody, nobody seemed to question that, either. "She's a pro who is committed to the cause," says Jennings. "She's an insder but she cares about doing this for the right reasons--and has always been invested in insuring that every American has quality, affordable coverage."

"She genuinely cares about the people in the progarms she’s worked on, and I think that goes back to her time in Tennesese state government," adds Peter Harbage, who worked for her in the Clinton administration and is now a health policy analyst at the Center for American Progress. "You have a person who really wants the programs to be successful, because she knows there are real people involved, and at the same time she is no-nonsense about policy--she has that consummate hard-head, soft-heart approach to thinking you learn about in public policy school."

--Jonathan Cohn

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