Daschle's Withdrawal Won't Derail Healthcare Reform

Reporting from Washington — If President Obama is to reshape the nation's healthcare system, he will have to do it without a lieutenant who combined a rare understanding of both healthcare and Washington politics.

But Tom Daschle's decision to withdraw from consideration for secretary of Health and Human Services appears unlikely to derail a reform movement that began even before Obama was elected.

"If anything, there's more urgency for us to keep up the momentum," Senate Finance Committee chairman Max Baucus (D-Mont.) said Tuesday after Daschle's announcement.

Skyrocketing healthcare costs and the growing ranks of the uninsured have driven a push for major action by business organizations, healthcare groups and consumer advocates.

On Capitol Hill -- where Democrats have commanding majorities -- senior lawmakers are moving ahead with plans for legislation to advance many of the goals outlined by Obama and Daschle.

But completing that process promises to be harder without Daschle, who was popular with lawmakers on both sides of the aisle and widely seen as a consensus-builder who could have helped shaped the grand compromise many believe will be necessary.

The soft-spoken South Dakota Democrat served 10 years as the Democratic leader in the Senate as part of a 26-year legislative career. After leaving Congress, he became a leading champion of healthcare reform and built relationships with key interest groups.

A keen student of the failures of previous healthcare reform efforts, Daschle also became a close advisor to Obama. Many believed their relationship would help advance the cause this year.

Now, the new president will have to find someone else to advance his most ambitious policy agenda. That selection process will likely take time, given the necessity to investigate candidates' backgrounds.

Few of the people mentioned Tuesday as possible replacements for Daschle would possess his level of Capitol Hill experience. A number of candidates have never served in Washington -- including Democratic Kansas Gov. Kathleen Sebelius, who is widely respected for her work on healthcare, and former Oregon Gov. John Kitzhaber, a doctor.

That lack of Capitol expertise was considered a major handicap for the Clinton administration 15 years ago when it tried to thread healthcare reform through what was, for much of the administration, an alien political culture.

Obama himself acknowledged his challenge Tuesday in an interview with ABC News.

"Tom Daschle would have been the best person to help shepherd through a healthcare bill through a very difficult process in Congress," the president said.

Nonetheless, many lawmakers said Tuesday they have no plans to slow down.

"Healthcare will stay on the top of the agenda because the American people want it and the president has said he will do it," said Rep. Henry A. Waxman (D- Beverly Hills), who is expected to play a key role in shaping healthcare legislation as chairman of the House Energy and Commerce Committee. "The rest of us just will have to work harder."

Baucus, who outlined his healthcare plan last year, and Sen. Edward M. Kennedy (D-Mass.), who chairs the Senate health committee, are working together on a reform bill they hope to introduce in the next several months.

John J. Castellani, who heads the influential Business Roundtable, said over the last month his group has actually been working more closely with members of Congress than with the new administration.

That effort builds on the emerging consensus that the federal government must act decisively to help cover the roughly 46 million people in America who lack health insurance.

Lawmakers and interest groups also agree that Washington must take aggressive steps to bring down costs and reward quality care.

And key players in the healthcare debate increasingly agree on the need for a large investment of taxpayer money on healthcare despite the burgeoning budget deficits.

Congressional Democrats have already begun that process with bills to spend billions of dollars on children's health coverage, health technology and health coverage for people who are losing their jobs.

Daschle was a leading champion of this approach, laying it out in his 2008 book on healthcare reform: "Critical: What We Can Do About the Health-Care Crisis." He had been actively tending to this agenda since December, when Obama asked him to lead the Department of Health and Human Services and head a new White House Office of Health Reform.

The former Senate leader met with interest groups and lawmakers while assuring Washington of the Obama administration's commitment to action despite the economic downturn and other competing priorities.

Several longtime observers of healthcare politics noted that it is Obama's engagement that is most crucial.

"Ultimately, the likelihood of healthcare reform depends on the commitment of the president and the key committee chairmen in Congress," said Ron Pollack, who heads Families USA, an influential consumer group and leading advocate of reform.

In television interviews Tuesday, the president repeated his desire to take advantage of the current economic crisis to tackle long-term issues such as healthcare, rather than defer them. Obama also seems unlikely to abandon his political strategy of relying on Congress to help lead the healthcare reform effort.

Daschle strongly advocated this approach, arguing that excluding lawmakers was one of the main reasons that Clinton's effort faltered in the '90s.

The West Wing of the White House still includes senior veterans of Capitol Hill including former Rep. Rahm Emanuel (D-Ill.), now Obama's chief of staff. Obama's new congressional liaison, Phil Schiliro, served previously as Waxman's chief of staff.

Janet Hook in our Washington bureau contributed to this report.