Democrats’ Health Care Brain Drain

They may own health care as an issue, but all their experts are retiring.

Congressional Democrats with experience on health care issues are retiring in droves, leaving the party without much of a bench on the issue.  (Flickr/Eric F. Savage)
National Journal
Sam Baker
Jan. 30, 2014, 2:38 p.m.

Con­gres­sion­al Demo­crats began the Obama ad­min­is­tra­tion with a deep bench on health care is­sues — one whose pas­sion and col­lect­ive ex­per­i­ence far out­stripped their Re­pub­lic­an ad­versar­ies. That dy­nam­ic has now al­most en­tirely re­versed.

Since their razor-thin Af­ford­able Care Act vic­tory, nearly all of the Demo­crat­ic law­makers most ex­per­i­enced and most pas­sion­ate on health care have either left Con­gress or an­nounced their plan to leave this year.

And that’s a prob­lem for Demo­crats, giv­en that their pas­sage of Obama­care has handed them re­spons­ib­il­ity for health care for the next dec­ade. Re­pub­lic­ans, mean­while, will take every op­por­tun­ity to at­tack the law — and blame any and all of the health care sys­tem’s prob­lems on it.

Henry Wax­man, the Cali­for­nia Demo­crat who shep­her­ded Obama­care through the House En­ergy and Com­merce Com­mit­tee, be­came the latest to head for the door Thursday when he an­nounced he wouldn’t run again. In­clud­ing Wax­man, four of the five com­mit­tee chair­men who helped write the law are gone or leav­ing.

Demo­crat­ic lead­ers and com­mit­ted lib­er­als can and will still de­fend Obama­care polit­ic­ally, along with the ba­sic idea of uni­ver­sal cov­er­age. But there aren’t many Demo­crats left who — like Wax­man and some of his de­part­ing Con­gres­sion­al col­leagues — are truly in­ves­ted in the ins and outs of the Af­ford­able Care Act as well as oth­er nitty-gritty health care is­sues. (Wax­man, along with Re­pub­lic­an Sen. Or­rin Hatch, es­sen­tially cre­ated the gen­er­ic-drug in­dustry.)

Take a look at this roster of Demo­crats who either chaired key com­mit­tees dur­ing the Obama­care de­bate or were oth­er­wise known for their in­volve­ment on health care is­sues:

SEN­ATE

  • Ed­ward Kennedy (chaired the Health, Edu­ca­tion, Labor, and Pen­sions Com­mit­tee; died)
  • Chris Dodd (ran the HELP Com­mit­tee while Kennedy was sick, re­tired)
  • Tom Har­kin (chairs the HELP Com­mit­tee now; re­tir­ing in 2014)
  • Max Baucus (chaired the Fin­ance Com­mit­tee dur­ing Obama­care markup; prin­cip­al au­thor of Obama­care; re­tired to be am­bas­sad­or to China)
  • Jay Rock­e­feller (No. 2 on Fin­ance Com­mit­tee; ad­voc­ate for Medi­caid; re­tir­ing in 2014)

HOUSE

  • Pete Stark (seni­or mem­ber of Ways and Means Com­mit­tee; ca­reer-long in­terest in health care; lost reelec­tion in 2012)
  • George Miller (Pelosi lieu­ten­ant; chaired Edu­ca­tion and Labor Com­mit­tee dur­ing Obama­care markup; re­tir­ing in 2014)
  • Henry Wax­man (chaired En­ergy and Com­merce dur­ing Obama­care markup; long ca­reer in health is­sues; re­tir­ing in 2014)
  • Allyson Schwartz (act­ive on Medi­care and the health care de­liv­ery sys­tem; re­tir­ing to run for gov­ernor of Pennsylvania)

And while Demo­crats’ ranks have di­min­ished, Re­pub­lic­ans’ have swelled.

There are now 21 mem­bers of the House GOP Doc­tors’ Caucus (not all of them are doc­tors, but they’re all health care pro­fes­sion­als), and some still prac­tice. Rep. Bill Cas­sidy, who’s chal­len­ging Sen. Mary Landrieu, still sees pa­tients — many of them on Medi­caid — when he’s back in his dis­trict, a fact he has em­phas­ized while at­tack­ing Landrieu for sup­port­ing Obama­care.

The ex­odus of ex­per­i­enced Demo­crat­ic law­makers also means a loss of ex­per­i­enced staffers, health care lob­by­ists noted. Some ex­per­i­enced health care aides cashed out after Obama­care passed, head­ing for luc­rat­ive lob­by­ing and con­sult­ing jobs, and some of those who re­mained will likely fol­low suit next year.

Com­mit­tees and lead­er­ship of­fices still need smart health care aides, as do in­di­vidu­al law­makers, but lob­by­ists are ex­pect­ing many of the long­time aides who worked for de­part­ing mem­bers to head for the exits them­selves.

Lob­by­ists said a hand­ful of Demo­crats, in­clud­ing Rep. Ron Kind, are carving out a place for them­selves in health care policy, and the party’s ef­fort to down­play the is­sue in light of Obama­care’s poor polling prob­ably isn’t mak­ing it a very at­tract­ive place for am­bi­tious law­makers to dis­tin­guish them­selves.

In terms of elec­ted of­fi­cials, Sen. Ron Wyden is eas­ily Demo­crats’ most prom­in­ent re­main­ing health care wonk. He’s tak­ing over the Fin­ance Com­mit­tee, which has jur­is­dic­tion over most fed­er­al health care pro­grams, and was already one of the party’s lead­ing health care thinkers.

Demo­crat­ic lead­ers haven’t al­ways loved his ideas — the White House struck a deal with Re­pub­lic­ans that axed a Wyden pro­vi­sion from the Af­ford­able Care Act, and he ruffled some feath­ers by work­ing with Rep. Paul Ry­an on a plan to par­tially privat­ize Medi­care.

But he’s un­deni­ably smart, and able to dis­cuss health care off the cuff. And it’s not like Demo­crats have many oth­er op­tions, at least for now.

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