Who Is Plan B for HHS?

President Barack Obama never thought he’d need a Plan B.

When it came to choosing a person to help deliver his top-tier domestic priority – health care reform – Tom Daschle checked all the boxes.

Daschle had legislative acumen, Washington connections and White House clout — a unique blend that made proponents of universal coverage so optimistic about passing legislation this year, and now so worried that goal is at risk.

Even Obama declined to sugarcoat the blow.

“I am absolutely convinced that he would’ve been the best person to help shepherd through what’s going to be a very difficult process to get health care for American families,” Obama said in an interview with CBS News .

No obvious replacement has emerged, although names are floating through Capitol Hill and the health advocacy community.

Kansas Gov. Kathleen Sebelius, a former health insurance commissioner, knows the issue and enjoys a relationship with Obama, but she doesn’t know Washington.

Former Oregon Gov. John Kitzhaber is also a doctor who started a grassroots group to push for an overhaul of the health care system. A downside, again, might be his unfamiliarity with Washington.

Supporters of ex-Democratic national chairman Howard Dean already formed a Facebook page calling for his appointment to the post, citing his background as a physician and his political skills. He would seem to lack bipartisan appeal.

John Podesta, Obama’s transition chief, earned a mention Tuesday by Ezra Klein at the American Prospect as “the only player who equals Daschle in stature.” Republican Mitt Romney – yes, Mitt Romney – got a shout-out from Karen Tumulty at Time for enacting universal health care coverage as the Massachusetts governor.

“There is no question this is a bump in the road,” said Ron Pollack, executive director of Families USA, which is intricately involved in the health care push.

But Democrats and health advocates, including Pollack, insisted their timetable for moving forward with health care reform will not stall – even as the cause suffers a series of unexpected setbacks. Not only did Daschle step aside, but Sen. Edward M. Kennedy’s health has kept him away from the Capitol.

“Let's face it, Sen. Kennedy was their most prodigious leader,” said Sen. Orrin Hatch (R-Utah). “He had the kind of swat on all the mainline Democrat groups, I don't know of anybody else who had that kind of swat; but he did.”

The stakes are high for Obama. He campaigned on a promise of delivering health care coverage to all
Americans by the end of his first term. He also views an overhaul of the system as essential to fixing structural problems in the U.S. economy.

Administration aides had talked of turning quickly to health care after Congress passed the economic stimulus package. The White House put a working session on health care on the March calendar. And Kennedy’s office continues to hold meetings twice a week with stakeholders in the health care debate.

Press Secretary Robert Gibbs said the administration’s work on the issue “won’t stop or won’t pause while we look for that nominee.”

“I don't think the effort slows down for health care reform, and I think Senator Daschle and others would admit that the effort is far bigger than any one individual,” Gibbs said Tuesday. “It's so important, it encompasses so much of our economy, and we understand that the system that we currently have whereby Americans pay more for health care and get less from it than virtually any industrialized country on the planet underscores that this is bigger than any one group or any individual.”

Yet Daschle was viewed as someone with unique qualifications.

As a former Senate majority leader, he knew the Hill. As Obama’s earliest, high-profile Washington backer, Daschle could tap a direct line into the Oval Office. As a senator who worked on health care and wrote a book this year about reforming the system, Daschle was steeped in the details of what went wrong during the 1993-94 debate and how to do it right this time.

Among his key lessons: move on health care reform as soon as possible after the election of a new president.

Politico staff writer Manu Raju contributed to this story.

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