5 Women Who Shape Health Care Policy

Sylvia Mathews Burwell is guiding the Affordable Care Act into its second year while Karen Ignagni is the health insurance industry’s top representative in Washington.

Planned Parenthood president Cecile Richards. 
©2012 Richard A. Bloom
National Journal Staff
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National Journal Staff
July 25, 2014, 1 a.m.

This year, Na­tion­al Journ­al‘s Wo­men in Wash­ing­ton list fo­cuses on wo­men who ex­er­cise power­ful in­flu­ence in five policy areas: en­ergy, health care, tech­no­logy, de­fense, and edu­ca­tion.

Bur­well, pre­vi­ously dir­ect­or of the White House budget of­fice, re­cently took Kath­leen Se­beli­us’s place as head of HHS. She is pop­u­lar on Cap­it­ol Hill and has a repu­ta­tion as a skilled man­ager. She’ll need those skills as she guides the Af­ford­able Care Act in­to its second year while keep­ing the rest of the de­part­ment hum­ming. Bur­well has already taken steps to re­or­gan­ize HHS, adding new po­s­i­tions with dir­ect over­sight of the in­sur­ance ex­changes.

With dir­ect re­spons­ib­il­ity for Medi­care, Medi­caid, and most of Obama­care, Taven­ner is on the hook for some of the most con­tro­ver­sial de­cisions in health care, from cuts in pro­viders’ Medi­care pay­ments to re­build­ing the ACA’s en­roll­ment sys­tem. Taven­ner, like Bur­well, came in­to the job with strong bi­par­tis­an sup­port and largely avoided any blame for Health­Care.gov’s rocky rol­lout. But CMS has come un­der fire from Re­pub­lic­ans over pro­posed cuts to Medi­care Ad­vant­age, and the agency is still sort­ing through a back­log of in­com­plete Medi­caid en­roll­ments.

Lam­brew, who has a back­ground in aca­demia, is Pres­id­ent Obama’s top health policy ad­viser and has provided a steady hand on the is­sue since the early days of the ad­min­is­tra­tion. She is deeply in­volved in the nitty-gritty of ACA im­ple­ment­a­tion and will have Obama’s ear in the next big front in the health care de­bate: cost con­trol.

As the health in­sur­ance in­dustry’s top rep­res­ent­at­ive in Wash­ing­ton, Ig­nagni has had an in­tense half-dec­ade, hav­ing guided AHIP through the de­bate over the Af­ford­able Care Act. Dur­ing the botched de­but of Health­Care.gov, in­surers ended up do­ing most of the work the web­site was sup­posed to do, thus win­ning cred­ib­il­ity as the pro­tect­ors of Obama­care. Ig­nagni’s next chal­lenge: what’s shap­ing up to be an all-out war between her in­dustry and phar­ma­ceut­ic­al com­pan­ies over the high cost of pre­scrip­tion drugs.

Richards is un­doubtedly one of the most power­ful wo­men in Demo­crat­ic polit­ics, and her status keeps grow­ing amid flare-ups ran­ging from Todd Akin to the Su­preme Court’s rul­ing lim­it­ing Obama­care’s con­tra­cep­tion man­date. She leads Planned Par­ent­hood’s day-to-day op­er­a­tions as well as its polit­ic­al arm, put­ting her squarely at the in­ter­sec­tion of health care policy and polit­ics.

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