In the wake of Tom Daschle’s implosion, media speculation on Barack Obama’s next nominee to lead the Department of Health and Human Services has focused mainly on four names. Three of them are (fairly) logical candidates for the job. One is not.
The name that doesn’t belong is Howard Dean’s. The former DNC chairman remains a beloved figure among his party’s grass roots and his background as a physician and as a governor who pursued health care reform in his state would seem to make him a decent HHS selection. Plus, he’d bring an outsize profile to the job, one equal to the massive task—overseeing the administration’s efforts to deliver universal health insurance—that will come with the HHS perch. Not surprisingly, Dean’s fans are pushing him aggressively for the job.
But we already know where Dean stands with the new president, whose first act after winning last November’s election was to tap Rahm Emanuel as his chief of staff. In 2006, Emanuel made it his mission to undermine Dean’s control of the DNC, vilifying him to the press, berating him with profanity-laced tirades in meetings and uniting the party’s Congressional leaders against him. When Obama appeared with Tim Kaine to announce the Virginia governor’s selection as the new DNC chairman early last month, Dean wasn’t invited—an oversight that was as rude as it was intentional. Fair or not, Obama clearly wants nothing to do with Dean.
The three other possible contenders make more sense, though each has obvious drawbacks.
Start with Kathleen Sebelius, the Kansas governor who, according to an Associated Press report on Sunday, is "very near the top" of Obama’s list. Unlike Dean, Sebelius has a strong relationship with Obama, whom she endorsed early in last year’s primary campaign and whose running-mate list she was also very near the top of last summer.
The case for choosing her rests mainly on her potential to work effectively with Republicans in Congress and to market an eventual health care plan to the general public. Right now, Sebelius isn’t a household name outside of Kansas, but her record there shows much promise: In a devoutly Republican state, she’s won two statewide elections and racked up enviable poll numbers. Her appeal to Republicans was strong enough, in fact, that in 2006 she actually convinced Kansas’ former Republican chairman, Mark Parkinson, to run on her ticket for lieutenant governor.
Of course, whether this appeal would be transferable to Capitol Hill, where the partisan lines are far deeper and better defined, is open to debate. But the real drawback to choosing Sebelius involves basic politics: Give her the HHS slot, and Democrats can say goodbye to a golden Senate pick-up opportunity in Kansas in 2010.
As we saw with his choice of Judd Gregg for Commerce secretary, midterm politics are on Obama’s mind as he fills out his cabinet. So it probably hasn’t escaped his notice that a poll released last week gave Sebelius double-digit leads over the two most likely Republican candidates for the seat of retiring Senator Sam Brownback next year. Democrats haven’t won a Senate race in Kansas since 1932, and without Sebelius on their ticket, that streak will surely be extended in ’10. But if she were to run, Democrats could very realistically emerge from Obama’s first midterm with more than 60 seats in the upper chamber. That’s a lot to give up for an HHS secretary, especially one who doesn’t have Capitol Hill experience.
Phil Bredesen, the Tennessee governor and another widely discussed HHS contender, lacks a Capitol Hill résumé as well. But like Sebelius, his success in a red state makes him an attractive option for Obama—someone who knows how to work with Republicans and appeal to voters outside of the Democratic base. Given the forces arrayed against any serious effort to overhaul the health care system, these are valuable attributes for an HHS secretary.
But does Bredesen actually share Obama’s goal of universal coverage? Before entering politics, he made his fortune by founding a commercial HMO, HealthAmerica. And as Tennessee’s governor, he decimated a Medicare program designed to cover low-income residents. Again, his managed care background might give Bredesen invaluable credibility with Republicans in Congress. But if he and Obama don’t see eye-to-eye on the basic philosophy of health care reform, he might not be a good choice to be the administration’s point man on the subject.
And then there’s Ron Wyden, who has somewhat quietly served as a senator from Oregon since 1996. Before that, he was in the House for 15 years. This extensive Capitol Hill experience sets Wyden apart from Sebelius and Bredesen. And it was, after all, his mastery of Çongressional politics that—in part—made Daschle such an attractive HHS choice for Obama in the first place.
And Wyden has made health care his pet issue in the Senate, pushing his Healthy Americans Act, which would, roughly, create a national version of the universal coverage plan adopted by Massachusetts in 2006. Plus, Oregon now has a Democratic governor, Ted Kulongoski, ensuring that Wyden’s seat would be filled by a fellow Democrat. (And that Democrat would be well positioned in 2010 as well, given the state’s blue tint.)
There are a few knocks on Wyden, though. One is that his low national profile as a senator suggests he’d lack the stature to sell an administration plan to the general public. As a public figure, Wyden tends to fade into the crowd, not stand out from it. Plus, his Congressional experience comes with a catch: Over the years, he’s rubbed plenty of his colleagues the wrong way. Plus, as with Bredesen, there’s a question of whether his own health care philosophy, seen by many on the left as too accommodating to the health care industry, is really in line with Obama’s.
There are plenty of other names being suggested for the post. To date, the craziest suggestions have involved Newt Gingrich and Mitt Romney (who’d only take the job for the opportunity to dramatically resign from it sometime in 2011 in an effort to make himself a hero to the right and to justify a 2012 presidential campaign). Obama probably won’t choose either of them, but given the drawbacks of the major contenders, his final choice may still be a surprise.