Republicans have not been eager lately to associate themselves with President George W. Bush. But the team advising GOP presidential hopeful Mitt Romney on health issues draws heavily from the Bush Health and Human Services Department when it was headed by Mike Leavitt, the man who will lead transition planning if Romney wins the White House.
Leavitt, the former Utah governor, is mild-mannered and not known for partisan rancor. A Mormon, he combines policy wonkery with political skill. If Romney wins, Leavitt would have a big role in implementing the health reforms that the campaign is proposing. As HHS secretary in the Bush years, he led the rollout of the Medicare prescription-drug benefit known as Part D—now one of the most popular components of the program.
The Part D plan reflects the Republican philosophy that increasing competition for consumers' health care dollars among private insurers will lower health care costs. That theory underpins Romney's arguments that seniors should be able to choose among private insurance companies' plans.
Medicare reform is an issue near and dear to Leavitt's heart: In an old biography from the HHS website, he warned of disaster in both Medicare and Medicaid and said it was crucial to put them on a more sustainable path.
Romney's health advisers include Tevi Troy, Leavitt's former deputy at HHS, and Thomas Barker, now a partner at Foley Hoag, who also worked for Leavitt at HHS. Another adviser is Scott Gottlieb, now with the American Enterprise Institute, who served as a senior adviser at the Centers for Medicare and Medicaid Services during the Bush years and later became a deputy commissioner at the Food and Drug Administration.
Troy said that Leavitt "rolled up his sleeves" in the prescription-drug program's implementation, even dropping in one Saturday at HHS's Baltimore office to work with the staff on it. Drawing on his political experience, he focused during the rollout on making sure seniors understood their choices. Douglas Holtz-Eakin, architect of 2008 GOP nominee John McCain's health care platform, said the experience with Part D's implementation would be a plus for Romney's health team. "They had to really think hard about the rollout, the presentation on websites, and just had to get it done in time with a short lead time," Holtz-Eakin said. And that experience could be useful in the transition of the entire Medicare program to private insurance plans. Of course, Holtz-Eakin said, the scale is "enormously larger."
Gail Wilensky, who advised McCain's campaign on health care, said Romney's advisers are "capable, competent individuals" whose political savvy would be helpful in guiding his efforts.
The goal to overhaul Medicare was sealed when Romney chose as his running mate Rep. Paul Ryan, R-Wis., the architect of a premium-support Medicare plan approved twice by the Republican-controlled House. Before the Ryan pick was even announced, former aides to the congressman, such as Matt Hoffmann and Jonathan Burks, had left their jobs on the House Budget Committee to work on the Romney campaign.