Nancy-Ann DeParle Speaks at Solomon Center Event

For its fall kick-off event on September 14th, 2017, the Solomon Center welcomed speaker Nancy-Ann DeParle to discuss the future of health care reform under President Trump. DeParle has worked on health care reform efforts from a number of angles. She was the Deputy Chief of Staff for Policy and the Director of the Office of Health Reform under President Obama and the Administrator of the Health Care Financing Administration under President Clinton. Previously, she worked at the Office of Management and Budget. Faculty Director Abbe R. Gluck, ’00, moderated the conversation.

Speaking about the current state of health care reform, DeParle described herself as more optimistic about the Affordable Care Act’s prospects than she had been in a number of years. The law, for the first time, is gaining popularity. Moreover, its momentum seems organic—the people pushing to keep the ACA are not unions or other typical players; they are ordinary people who are engaging because they see the urgency of the situation. Young people, in particular, have gotten more involved in the efforts, she said. 

The ACA, DeParle maintained, has been successful, even with mountains of opposition. Even now, there are no counties that have no coverage and low-income individuals can still get help with their premiums. She pointed to California as a “textbook case of why markets can work.” California worked on a bipartisan basis to expand Medicaid and actively managed its Exchange so that less profitable markets would receive adequate coverage as well, she noted.

DeParle was less optimistic about single-payer health reform. One of the largest issues with these proposals, she noted, is that employers want to continue providing health insurance. This was one of the reasons that the Clinton health care reform efforts failed. The effort might succeed in the future, but she was skeptical that the current political will would be sufficient to pass such a bill.

The best way forward, she suggested, would be to focus on opposing Republican anti-ACA efforts. These efforts, she noted, are less about “repeal and replace” and more about “shirk and sabotage.” Instead, DeParle is hopeful that Congress will come up with a bipartisan plan to “repair and rebrand.” “The policy bones of the ACA could be made to work,” said DeParle, so long as Congress and the President work to stabilize insurance markets and boost enrollment. “The goal is to get affordable, high-quality coverage. We can still get that with the ACA."