Jeanne Lambrew

Why She Matters Lambrew, a health-policy expert, academic and former senior fellow at the Center for American Progress (CAP), is heading the Health and Human Services Office of Health Reform, under HHS Secretary Kathleen Sebelius. Lambrew, was originally set to work at the White House Office of Health Reform as deputy to Tom Daschle, Obama's original choice for Health and Human Services secretary. Daschle and Lambrew worked together at CAP and co-authored a book on health-care reform. But Daschle withdrew his nomination over tax issues and former Kansas Governor Kathleen Sebelius took became HHS head; Nancy-Ann DeParle took over the White House Office of Health Reform. But Lambrew survived the turmoil and has shifted to the Health Reform Office within HHS that mirrors the White House one. Lambrew already has one unsuccessful health-care reform attempt under her belt. She served at Bill Clinton’s HHS during the failed 1993 bid to reform the system. Furthermore, Lambrew was a White House health-policy aide during Clinton’s second term, working on the president’s 1993 Medicare overhaul plan and a long-term care initiative as well as oversight of Medicaid and disability programs. Lambrew helped create the State Children’s Health Insurance Program (SCHIP), and has said she wants to focus the attention of the American health-care system on preventing illness. In the book she co-authored with Daschle, they promote universal health care and propose creating a central health agency similar to the Federal Reserve system. Path to Power Lambrew was on the rowing team at Amherst College, graduating in 1989. She went on to the University of North Carolina at Chapel Hill, where she received both a master’s degree and a Ph.D. in health policy from the school of public health. She was special assistant coordinating Medicaid and state studies at HHS during Bill Clinton’s failed attempts to reform health care in 1993 and 1994. She stayed at HHS through 1995, coordinating budget proposal analysis. Lambrew joined the faculty of Georgetown University in 1996 as an assistant professor of public policy. Clinton Administration During Bill Clinton’s second term from 1997 to 2001, Lambrew served as the health- policy associate director for the Office of Management and Budget and a senior health analyst for the National Economic Council. At the White House, she helped develop health-care proposals, including Bill Clinton’s Medicare reform plan and an initiative on long-term care. Lambrew was the lead on drafting and implementing the State Children's Health Insurance Program (SCHIP), which offers federal funding to states to cover children without health insurance. The program was designed for families who don’t have insurance but have incomes too high to qualify for the government-sponsored Medicaid program. In 2007, President Bush twice vetoed legislation that would have expanded the program. One of Obama's first moves was to reauthorize and expand SCHIP.(1) While working at the White House, Lambrew was also an associate professor at George Washington University’s School of Public Health and Health Services. She continued there until 2007. Center for American Progress In 2003, Lambrew became a CAP fellow. Many new Obama administration officials were drawn from the liberal think tank started by former Clinton Chief of Staff John Podesta. As a fellow, Lambrew worked closely with Daschle. Daschle had long been interested in health-care reform, and the two appeared on panels together and co-authored the 2008 book, "Critical: What We Can Do about the Health-Care Crisis". In 2007, Lambrew joined the faculty of the University of Texas’ Lyndon B. Johnson School of Public Affairs (but continued her work with CAP). As an associate professor of public affairs specializing in health care and policy, she researched Medicaid, Medicare, the uninsured and long-term care. Obama Administration In Late 2008, Lambrew became a part of the Obama-Biden transition team's health care task force. The task force was led by Daschle, who at the time was set to hold the dual role as HHS secretary and head of the White House Office of Health Reform. Lambrew was installed as his deputy at the White House policy shop. But in February Daschle withdrew his nomination after it became known that he failed to pay taxes on perks from private-sector consulting he had done. Lambrew moved over to HHS as an adviser, while the administration scrambled to find people to fill Daschle large helath-reform shoes. They settled on two: Kansas Gov. Kathleen Sebelius as HHS secretary and Nancy-Ann DeParle as head of the White House health-reform shop. Sebelius created an HHS Office of Health Reform, a sister office to the White House shop. Lambrew was installed as the head of the HHS office, working closely with both Sebelius and DeParle on overhauling the nation's health system. The Issues Lambrew told an Iowa audience in early 2007 that the time was right for health-care reform, calling it crucial to American business interests. "This has become an economic competitiveness issue," she said.(2) The Washington Post summarized Lambrew’s key areas of focus, saying, “The nation's ability to respond to natural or man-made crises is weak, as evidenced by the poor response to Hurrican Katrina. Chronic illnesses such as diabetes have been given short shrift, and little has been done to prepare for the long-term health needs of an aging population.”(3) Lambrew co-authored Tom Daschle’s 2008 book, "Critical: What We Can Do about the Health-Care Crisis".(4) In it, they propose creating a federal health board, a non-political organization that would operate like a health care-focused version of the Federal Reserve. Lambrew has also suggested insuring more people in the short-term by raising the income limit for people to receive government-funded Medicaid coverage. “It will not be easy,” the Washington Post said. “Most states, which help underwrite the program, are broke.”(3) Lambrew argues that political ideology, not science, shaped too many of the George W. Bush administration’s health policies. “Many of those had to do with sexuality and reproductive health, embryonic stem cells and allowing private firms to shape Medicare insurance plans,” The Washington Post reported.(3) Universal Health Care Lambrew has written extensively about expanding health insurance coverage to all Americans by expanding government programs that already exist. The Center for American Progress' ‘Progressive Prescriptions for a Healthy America Plan’ would merge Medicaid, Medicare, and employers’ plans with an expanded Federal Employee Health Benefits Program.(5) “The plan would provide all people lacking job-based insurance with access to the same private health plans offered to federal employees and members of Congress,” Lambrew and other CAP fellows wrote in a 2005 Health Affairs article.(6) The plan would include cutting costs by increasing the use of technology, including the creation of electronic medical records as well as focusing on preventing disease. Prevention and the Wellness Trust “Preventable disease is not a failure of medical science but a failure of our health care system,” Lambrew wrote in a 2007 commentary for Forbes.com.(7) Lambrew’s health program would have an increased focus on preventing disease before it begins. In an April 2007 paper for the Brookings Institution entitled "A Wellness Trust to Prioritize Disease Prevention," Lambrew wrote, “Chronic and preventable diseases now account for most of the deaths and costs in the system.”(8) She proposed financing preventive medicine outside of the traditional health-insurance system through creating a Wellness Trust, a new agency under HHS, to finance and coordinate all illness prevention in the United States. “The Trust would be the primary provider of prevention priorities for all Americans, irrespective of insurance status,” she wrote.(8) Federal Health Board In "Critical: What We Can Do About The Health-Care Crisis,"(4) Lambrew and Daschle wrote about the need for a federal health board modeled after the Federal Reserve system. The board would set standards and systems, create guidelines about which treatments and procedures are most cost-effective and have authority over federally-funded health-care programs such as Medicare and Medicaid. The authors argue the public board and its guidelines would influence private insurers. The authors envision a health board composed of independent experts who are above political scuffling. “Congress and the White House would relinquish some of their health-policy decisions to it,” Daschle proposes in the book. “For example, a shift to a more effective drug service would be accomplished without an act of Congress or the White House."(9) Funding Health Care CAP’s ‘Progressive Prescriptions for a Healthy America Plan’ proposed funding for a massive health-care overhaul by instituting a value-added tax. “A VAT is a tax on the value of a good or service added in its various stages of production—effectively the difference between what a business sells and what it buys from other businesses.” Lambrew wrote in a 2005 article. “A broad-based VAT in the range of 3-4 percent with targeted exemptions (for example, exempting small businesses, food, education, religion, or health care) would be sufficient to support the plan’s investment.”(5) The Network As a health-policy adviser to Barack Obama during the 2008 campaign, Lambrew joined Harvard’s David Blumenthal and Jeffrey Liebman, Stuart Altman of Brandeis and Austan Goolsbee of the University of Chicago. Campaign aides Heather Higginbottom, Jason Furman and Neera Tanden, and Obama Senate staff member Dora Hughes also advised the nominee on health-care issues.(10) At HHS, Lambrew reports to Secretary Sebelius. On Lambrew's team are advisers Tanden, Michael Hash and Meena Seshamani. Linda Douglass heads communications. The New York Times called the Center for American Progress a “government in exile for liberal policy experts.”(10)Lambrew was wooed there by CAP’s founder, John Podesta, who was chief of staff to Bill Clinton and co-chairman of Barack Obama’s transition team.(10) Lambrew co-authored a book with Obama's original Health and Human Services Secretary-designate Daschle. "Critical: What We Can Do about the Health Care Crisis" went on sale in February 2008.(4) Campaign Contributions Lambrew has been donating to liberal causes and candidates since 2004, when she gave a total of $2,500 to Sen. John Kerry’s (D-Mass.) presidential campaign. She gave $1,000 to Hillary Rodham Clinton in December 2007, and another $500 to Clinton in February 2008. She gave the maximum allowable to Barack Obama starting in June 2008, and also ponied up $500 to Clinton at the end of August. Lambrew has been a regular supporter of Judith Feder (D), who worked at Georgetown University at the same time as Lambrew. The health-policy expert and former dean of the Georgetown Public Policy Institute unsuccessfully ran for the U.S. House seat from Virginia’s 10th Congressional District in 2006 and 2008. Lambrew gave Feder’s campaign a total of $2,900 in 2006, according to the Center for Responsive Politics. Lambrew donated $1,500 to Feder in the fall of 2007 and another $800 in the spring of 2008. In 2005, she gave $250 to Montana State Auditor John Morrison’s (D) unsuccessful Senate campaign. Morrison’s Insure Montana program, passed in 2005, uses revenue from tobacco taxes to help small businesses offer employee health insurance. Footnotes 1. Pear, Robert, “Senator Takes Initiative on Health Care,” The New York Times, November, 11, 2008 2. “Iowa Lawmakers Mull Health Care Options,” The Associated Press, January 18, 2007 3. Connolly, Ceci, “HHS Will Be Shepherding Health-Care Reform,” The Washington Post, December 5, 2008 4. Daschle, Tom, Jeanne M. Lambrew and Scott S. Greenberger, "Critical: What We Can Do about the Health-Care Crisis," New York: MacMillan Books, 2008 5. “Nonfiction Reviews,” Publishers Weekly, January 7, 2008 6. Lambrew, Jeanne M., John D. Podesta, and Teresa L. Shaw, “Change in Challenging Times: A Plan for Extending and Improving Health Coverage,” Health Affairs, March 23, 2005 7. Lambrew, Jeanne and John Podesta, “Commentary,” Forbes.com, September 4, 2007 8. Lambrew, Jeanne M., “A Wellness Trust to Prioritize Disease Prevention,” The Hamilton Project Discussion Paper, The Brookings Institution, April 2007 9. Tom Daschle, Jeanne M. Lambrew, and Scott S. Greenberger, “Critical: What We Can Do about the Health Care Crisis,” New York: Thomas Dunne Books, 2008 10. Savage, Charlie, “John Podesta, Shepherd of a Government in Exile,” The New York Times, December 6, 2008