How Kathleen Sebelius Got Lucky
For Obama’s new health czarina Kathleen Sebelius, the yellow brick road from Kansas to Washington has been a long and winding one. But she can build bipartisan support to take health-care reform to the other side of the rainbow.
Democratic majorities in both the House and Senate. Real working majorities, and a president with an aggressive, systematic program to reform the American health-care system. Wearing her trademark red-slippers pin as she moves to Washington, Kathleen Sebelius is not in Kansas anymore. During her career in Kansas politics, spanning more than two decades, Sebelius never served with a Democratic legislative majority.
In her eight years as insurance commissioner, an elected position, Republicans dominated the legislature; likewise in her six-plus years as governor, Sebelius has consistently faced sizable Republican legislative majorities. Those majorities, often anchored by social conservatives in the House, opposed almost everything she proposed, especially on health care. Increase tobacco taxes to expand children’s health coverage? Nope. Expand S-Chip coverage to insure more kids for a modest $5 million? Sorry.
As much as anyone in Obama’s Cabinet, her mix of political skill and policy expertise mirrors that of the president.
Despite winning two gubernatorial elections by substantial margins (58 to 42 percent in 2008) in a state where less than one-third of the voters are Democrats, as governor Sebelius faced intractable partisan opposition on most of her legislative agenda. Only with school-finance reform, when the courts dictated increased funding, did Sebelius demonstrate her ability to combine policy and politics to emerge with a major legislative victory on a key statewide issue.
Now, suddenly and by happenstance, Kathleen Sebelius finds herself astride the unruly beast of the Health and Human Services Department. Not only must she address the myriad issues and agencies that compose HHS, but she must also play a major role in formulating and passing Obama’s complex health-care reform package. Tough assignments, to be sure, but in Washington, Sebelius will potentially have the votes to move change through Capitol Hill, a far cry from her experience in Kansas.
To be fair, when she did have bargaining leverage as governor, particularly with the court-mandated school-finance reform, Sebelius proved herself a flexible but tough negotiator, who eventually cut a deal with moderate, pro-education Republican legislators to produce almost the maximum amount of school funding possible.
Sebelius has lived a political life, helping her father, John Gilligan, campaign for Congress, then governor of Ohio, before she started first grade. She married the son of a Kansas Republican congressman, Keith Sebelius, picking up a surname that would serve her well in the western part of the state, long after her father-in-law had died. As she tells the story, “People would ask me, ‘How’s old Keith doing?’ And at first I’d explain that he had died. But pretty soon, I’d simply say, ‘Old Keith is doing just fine.’”
Moving back to Kansas with her husband Gary, she picked up a master’s degree in public administration at the University of Kansas, became a lobbyist for the state trial lawyers, and won a seat in the state legislature in 1986. In 1994, a disastrous year for Democrats in Kansas and across the nation, Sebelius used issues of competence and corruption to wrest the state insurance commissioner post from a good-old-boy Republican incumbent. Casting herself as a reformer and innovator, she refused to take contributions from insurance companies and fashioned a responsive, consumer-oriented department. But a low-level state office is scarcely a firm stepping stone to the governorship.
In 2001, Sebelius got lucky. An out-of-state private company, Anthem, sought to purchase Kansas Blue Cross/Blue Shield. As insurance commissioner, Sebelius squelched the deal, arguing that rates would rise. In 2002, the state Supreme Court ruled that she had the power to reject the offer, and her consumer-oriented policy triumph became the cornerstone of her gubernatorial campaign.
As governor, the Sebelius record appears mixed, although she has accomplished a good deal more than meets the eye. On major issues, with the exception of the school-finance expansion, the Democratic governor and the Republican legislature have rarely worked well together. Beyond ordinary partisan politics, various GOP legislative leaders have eyed the governorship and labored to deny Sebelius credit for any policy successes. Much to their dismay, she has frequently used her political skills to outmaneuver the Republican legislators, often with innovative executive-branch actions.
To wit, Sebelius faced a deep fiscal crisis in 2003 when she became governor. Bill Graves, her Republican predecessor, had left the state almost broke. GOP legislators were confident that, contrary to her campaign promises, she would be forced to raise taxes. But with a veteran budget director and a combination of political and administrative skills, the governor shuffled funds, deferred some payments, while speeding the collection of various receipts. The result? No tax hikes and the ultimate judgment that none were necessary. Her job-approval ratings rose into the mid-60-percent range, where they have remained.
Beyond her well-publicized victories on the budget and school finance, Sebelius has also proven an able administrator, often working behind the scenes to streamline and update the state government’s structures and practices. Finding the cabinet departments isolated from each other upon arriving in the governor’s office, Sebelius pushed hard—and successfully—for systematic cooperation among agencies. And in 2008 her administration negotiated a labor agreement that reduced the number of bargaining units from 63 to 17. Not a single article was written about this change, which demonstrated her ability to work with unions to break down the calcification that overtakes most bureaucracies.
In short, for Sebelius, governing is important, because policies will be more effective if they are well administered. Moreover, good policies will make for positive political outcomes—in this case, she won a solid reputation as an administrator, which offset her inability to effect much large-scale change.
In heading off to Washington, Sebelius’s ability to combine policy and politics will have to translate to a larger arena and a far more complex set of issues. As much as anyone in Obama’s Cabinet, her mix of political skill and policy expertise mirrors that of the president. And much like Obama, Sebelius is pragmatic, while remaining focused on long-term goals. In Washington, with a Democratic wind at her back, she’ll be more liberal than in Kansas, and eager to work with Democratic legislators who share her health-care aspirations. To be sure, she faces formidable problems, but with policy expertise, administrative skills, and political sensitivity—supported by congressional majorities—Kathleen Sebelius gets to play a much stronger hand than she ever had as governor. It’s a new world for her, but one in which she is well prepared to succeed.
Burdett Loomis is a professor of political science at the University of Kansas. He worked for Governor Sebelius as director of administrative communication in 2005.