The 2,000-plus page healthcare reform bill, it turns out, was just an outline. As in all other newly minted laws, the provisions themselves are only the beginning. The real work begins after the bill is passed, when policy is translated into practicality. Healthcare reform now occupies that very limbo-like status between the promise and the proof in the proverbial pudding.
The top-tier government administrators charged with making healthcare reform actually happen have a big job ahead of them. And the Obama administration has appointed an implementation troika of experienced pros to lead the way.
In an April 19 article, The New York Times offers extended profiles of the three top appointees: Jay Angoff, whose bailiwick will be regulating insurers; Jeanne M. Lambrew, who will work on expanding coverage; and Phyllis C. Borzi, who will oversee employers in the new healthcare landscape. Each has an impressive history: Clearly, these are not political appointees of the “heckuva job, Brownie” variety.
As director of the Missouri Insurance Department during the 1990s, Angoff earned a reputation as a dogged and knowledgeable administrator, who won a tough legal battle with Blue Cross/Blue Shield. Lambrew was one of the chief architects of the Children’s Health Insurance Program (CHIPS). Borzi, with 35 years’ experience working on employee benefits, is one of the nation’s leading experts on the law that governs workplace benefits. Each has earned the grudging respect of some of the staunchest opponents of healthcare reform.
No doubt, as they put healthcare into play in the real world of hospitals, workplaces, doctors’ offices and the executive suites of the insurance industry, the threesome will meet some strong resistance. But the fact that Angoff, Lambrew and Borzi are not universally loved by insurers and employers offers a hopeful sign that we might actually see effective reform. Their ability to resist the pressure to water down the intent of the law, and their know-how in creating realistic regulations that will engender a new day in healthcare, will be critical in the success of what the New York Times calls, “one of the most profound changes in social policy in generations.”
Their efforts will be a backstage drama worth watching closely.