Thompson Prepares for Confirmation Hearings
To prepare for impending confirmation hearings, HHS Secretary-designee and Wisconsin Gov. Tommy Thompson (R) is spending two days in Washington, D.C. this week, the Milwaukee Journal Sentinel reports. According to a Senate aide, Thompson will participate in two hearings, one of which is likely to occur before the Jan. 20 inaugural. Thompson will appear before the Senate Finance Committee and the Senate Health, Education, Labor and Pensions Committee. The HELP panel likely will quiz Thompson on the FDA, CDC, NIH and other health agencies, while the Finance Committee likely will focus on Medicare and Medicaid issues. Michael Siegel, a spokesperson for Sen. Max Baucus (D-Mont.), the ranking Democrat on the Finance Committee, said that Thompson also could be asked about a "range of issues," including the economy, work force and minimum wage. After Thompson's appearance, the Finance Committee votes on his nomination. A majority vote sends the nomination to the full Senate. The HELP panel does not vote on the nomination. According to Joe Karpinski, spokesperson for Sen. Jim Jeffords (R-Vt.), the ranking Republican on the HELP panel, Thompson can expect a "very supportive, friendly" tone from fellow Republicans. However, Thompson's support of embryonic stem cell research could prove a "potential flash point" with abortion-rights opponents who support a ban on such research, the Journal Sentinel reports (Skiba, Milwaukee Journal Sentinel, 1/8).
If Thompson successfully moves through the confirmation process, the AP/St. Paul Pioneer Press reports that "he would be in a position to grant several exceptions to federal rules his [Wisconsin] administration has sought." His nomination marks the "first time [HHS] has encountered an incoming governor with requests pending before the agency," the AP/Pioneer Press reports. Wisconsin has three pending waiver requests before HHS. The HHS secretary has final approval of all waiver applications, but HHS administrators also can approve waivers. One waiver would allow Wisconsin to use CHIP program money to provide health coverage for parents under the state's BadgerCare program (Ross, AP/St. Paul Pioneer Press, 1/9). Another waiver would allow an adult with mental illness to continue receiving health care coverage even after his or her child has been taken from the home because of safety concerns. Currently, a parent loses his or her Medicaid coverage "the moment" a child is removed from a home. The third waiver would extend Medicaid eligibility for family planning services to women ages 15-44 whose incomes are 185% of the poverty level or less. Three other waivers are pending before other agencies or are currently being crafted. Those include:
- A waiver before the Social Security Administration to remove income limits for people with disabilities on Medicaid,
- A waiver being crafted to extend Medicaid to people with HIV who earn no more than 200% of the poverty level, and
- A waiver for a test program that allows the elderly and their relatives to "determine specific health care needs, how they could be provided and coordinated locally and what those services will cost" (AP/St. Paul Pioneer Press, 1/9).
HHS rules ban federal officials for one year from making decisions that "directly affect their previous employers," the AP/Pioneer Press reports. If Thompson is confirmed, HHS "ethics lawyers" will determine if the rules apply to Thompson (Ross, AP/St. Paul Pioneer Press, 1/9).
In an interview with the Los Angeles Times, sitting HHS Secretary Donna Shalala said that as HHS secretary, Thompson's "biggest challenge will be to stop thinking about Wisconsin when sitting at my desk -- his desk now." Shalala, who worked for Thompson as chancellor of the University of Wisconsin-Madison before she became HHS secretary, "predicted" that one of the "first and biggest fights" Thompson will encounter is "whether federal support for Medicaid ... should be provided with block grants," the Times reports. In 1995, Thompson led a group of governors to convert Medicaid into a block grant, an effort that President Clinton halted. Shalala added that the incoming administration would leave many of the current department's initiatives in place. In addition, she "said it is unlikely" that the incoming administration would change policies regarding embryonic stem cell and fetal tissue research or the FDA approval of abortion drug RU-486. Commenting on the overall role of the HHS Secretary, she said, "In the end, [the incoming administrators] will have to sort out whether they are trying to write laws for the best states or to write laws to make sure people are treated fairly no matter where they live in the United States, which is the particular role of the federal government" (Rubin/Cimons, Los Angeles Times, 1/9).
Although many conservatives have been "gleeful" about Thompson's nomination, the New Republic writes "[d]on't be surprised if, within a year or two, Thompson has lost favor among conservatives." While Thompson exhibits characteristics of most conservatives -- "attacking big government," opposing abortion rights -- he also has expanded Wisconsin's state-run health program and promoted stem-cell research. The New Republic identifies "a pattern" with Thompson: "He starts off making doctrinaire conservative pronouncements ... But once he actually has to run things, he veers left, in many cases embracing large government programs that, if applied on a federal level, would make Republicans apoplectic." Such is the case with Wisconsin's BadgerCare program. While other governors were "less enthusiastic" about even starting up children's health insurance programs, Thompson "eagerly" introduced eligibility limits of 200% of the poverty level and applied for a federal waiver to make parents eligible for the program, as well. As HHS secretary, Thompson's "penchant for spending money and expanding programs will run up against right-wing doctrine on fiscal policy and the role of government," the New Republic predicts. In Wisconsin, the magazine notes, Thompson "created the very kinds of programs that [Vice President Al] Gore advocated and [President-elect] Bush bashed" (Cohn, New Republic, 1/15 issue).