A Secretary, but Not a Czar

President Obama, as expected, named Kansas Gov. Kathleen Sebelius (D) as his nominee for Health and Human Services secretary this afternoon. As Obama's top health lieutenant, Sebelius will help lead the charge for health reform in the first year of Obama's administration. But to call her a "czar" might be overstating things.

Sebelius has a background in health reform dating back to her pre-governor days, having served for eight years as state insurance commissioner. If confirmed as HHS secretary, she will be the primary spokeswoman for Obama's ambitious health reform initiative--for which $634 billion has been set aside over the next decade in Obama's recent budget proposal.

The Kansas governor "knows health care inside and out," Obama said today as he announced her appointement, promoting his new pick. "She's won praise for her expertise from stakeholders across the spectrum, from consumer groups to insurers. Over eight years as state insurance commissioner, she refused campaign contributions from insurance companies and protected the people of Kansas from increases to their premiums by blocking a takeover of the state's largest insurer."

Her role in the post, however, likely won't be as sweeping as that advertised for Obama's first choice to lead HHS, Senate Majority Leader Tom Daschle (D-S.D.). And, while we will have to wait and see what Sebelius does in the new job, the tag of "health czar" that was quickly applied to Daschle may not fit so accurately with Obama's new nominee.

The reasons are twofold.

First, a major selling point for Daschle's broad authority over health reform was his massive rolodex of friends and working acquaintances in Congress. As former Senate majority leader, personally liked both by Democrats and Republicans, his relationships in the Capitol were supposed to be integral in shepherding ambitious reform through Congress, to Obama's desk. As a governor, Sebelius doesn't have those relationships--at least not to the extent Daschle does.

Second, Daschle was supposed to occupy two offices with authority over health reform: HHS secretary and director of the White House Office for Health Reform--a new office created by Obama's transition team in December. Sebelius won't occupy the latter post; instead, Obama named Tennessee Department of Human Services Commissioner Nancy DeParle today to fill the slot. Insofar as the term "czar" applied to Daschle's mandate to lead more than one office, Sebelius' appointment is undeniably less Russian.

So Daschle's absence has been filled by two replacements, not just by Sebelius--even if HHS secretary is the most high profile health job in the nation, and even if it will place the health reform crusade in her hands.

It's unclear who, between Sebelius and DeParle, will figure more prominently in shepherding Obama's massive health care reforms through Congress: "Sebelius is going to have a broad range of responsibilities," an administration official told me on background. "I'm not sure at this point we would rank who's going to have more impact."

As he announced Sebelius' nomination today, Obama also announced a health care reform summit to be held at the White House this Thursday. If last week's fiscal responsibility summit serves as any indicator, Obama and his team will ask Democrats and Republicans alike for ideas to help shape the health policy initiative and will try to foster good will by building rapport with the GOP. In short, it will kick off Sebelius's and DeParle's new responsibilities as policy specialists and health lobbyists for the Obama administration.

Let the health games begin.