Washington’s Health Care Power Brokers

The Commander in Chief has shown his influence over the health care system through his pioneering of the most significant health care reform legislation in decades. But his leadership will face even sterner tests in 2011 on both the legislative and judicial fronts. After a Virginia court decision said it is unconstitutional to require individuals to purchase medical coverage, 20 other states lined up behind similar challenges to PPACA. And in dealing with the new Congress, Obama will again need to explore compromises in adjusting the law, especially with newly empowered members of the GOP who don’t wish to be seen as compromising. All will test the powers of Obama’s persuasion. Just before the new Patient Protection and Affordable Care Act was signed into law, President Obama underlined the legislation’s significance. “Is this the single most important step that we have taken on health care since Medicare? Absolutely. Is this the most important piece of domestic legislation in terms of giving a break to hardworking middle class families out there since Medicare? Absolutely. Is this a vast improvement over the status quo? Absolutely,” he said.

In his new role as the Speaker of the House replacing Rep. Nancy Pelosi (D-Calif.), Rep. John Boehner (R-Ohio) will have considerable sway over what appropriations will be given to implementing PPACA. He has vociferously declared his opposition to the health care reform law passed in March and has vowed to repeal and replace the landmark legislation. After Republicans won the House in the most recent election, Boehner promised, "I think it's important for us to lay the groundwork before we begin to repeal this monstrosity and replace it with commonsense reforms that will bring down the cost of health care in America."

As Secretary of the Health and Human Services department, Kathleen Sebelius oversees the implementation of the recent health care reform legislation. This is broad task as the Patient Protection and Affordable Care Act makes about 3,000 references starting with "The Secretary of Health and Human Services should…" At a National Business Coalition on Health conference in November, Sebelius optimistically proclaimed that "Today, it’s possible to envision a future where employers are no longer shackled by soaring costs and poor outcomes; where businesses can invest in a healthy and productive workforce; where employees get the right care at the right time, each and every time; and where providers get the right incentive to provide the care that we know works best."