From Flues to Flu

Many inside the beltway expressed surprise at President Bush’s decision to move former Utah Gov. Michael Leavitt from the Environmental Protection Agency to the Department of Health and Human Services. Mr. Leavitt, who has a reputation as a pragmatic dealmaker, is a good choice for the department that oversees Medicare and Medicaid, the Food and Drug Administration and the Centers for Disease Control and Prevention.

If dealing with constant criticism from environmental groups and opposing pressure from industry groups was difficult – Mr. Leavitt gave no outward indications it was, but seems eager to leave the EPA after only 13 months – remedying an impending Medicare shortfall, safeguarding our food supply from terrorists threats and ensuring there is enough flu vaccine will be even more trying.

If confirmed, Mr. Leavitt will take over a department with an annual budget of $543 billion a year, more than 65 times larger than that of the EPA or Utah. Despite the size of the HHS department and the accompanying challenges, Mr. Leavitt has experience dealing with the complexities of health care. As chairman of the National Governors Association, he sought more authority for states to change Medicare and welfare programs. As Utah governor, Mr. Leavitt obtained a waiver that allowed the state to expand its Medicaid program by providing limited benefits to about 20,000 low-income residents with no health insurance. Benefits of others already in the program were cut to allow more people to be served. Critics charge that the benefits offered to new participants were so minimal that they were barely insured.

On a much larger scale, Mr. Leavitt must now tackle the rapid growth in the number of people without health insurance while also trying to rein in government health care spending to reduce the federal deficit.

Mr. Leavitt’s move now leaves a vacancy at the EPA. Prior to Mr. Leavitt’s short tenure, former New Jersey Gov. Christine Whitman headed the agency for two years before resigning. While she was sometimes at odds with the administration over environmental policies, Mr. Leavitt took a quieter approach.

No matter what their style, the new head of the EPA will be expected to carry out the administration’s policies, even if they adversely affect the environment. The White House has made it clear that it expects to pass its Clear Skies initiative soon. The plan would result in slower and smaller improvements in air quality than the Clean Air Act. The administration has also pushed for a gutting of rules requiring power plants and factories to install new pollution control equipment when major upgrades are made and it advocates a mercury trading program rather than stringent rules to reduce emissions of the toxic metal. It has also rejected studies and recommendations on curbing climate change.

In some respects, it doesn’t matter who heads the agency. Its direction is already set. The only question is how vigorously states like Maine move in the opposite direction, either through court challenges or regulations of their own.