Stem Cell, Climate Rules Among Targets of President-Elect's Team

By Ceci Connolly and R. Jeffrey Smith

Washington Post Staff Writers
Sunday, November 9, 2008; Page A16

Transition advisers to President-elect Barack Obama have compiled a list of about 200 Bush administration actions and executive orders that could be swiftly undone to reverse White House policies on climate change, stem cell research, reproductive rights and other issues, according to congressional Democrats, campaign aides and experts working with the transition team.

A team of four dozen advisers, working for months in virtual solitude, set out to identify regulatory and policy changes Obama could implement soon after his inauguration. The team is now consulting with liberal advocacy groups, Capitol Hill staffers and potential agency chiefs to prioritize those they regard as the most onerous or ideologically offensive, said a top transition official who was not permitted to speak on the record about the inner workings of the transition.

In some instances, Obama would be quickly delivering on promises he made during his two-year campaign, while in others he would be embracing Clinton-era policies upended by President Bush during his eight years in office.

"The kind of regulations they are looking at" are those imposed by Bush for "overtly political" reasons, in pursuit of what Democrats say was a partisan Republican agenda, said Dan Mendelson, a former associate administrator for health in the Clinton administration's Office of Management and Budget. The list of executive orders targeted by Obama's team could well get longer in the coming days, as Bush's appointees rush to enact a number of last-minute policies in an effort to extend his legacy.

A spokeswoman said yesterday that no plans for regulatory changes had been finalized. "Before he makes any decisions on potential executive or legislative actions, he will be conferring with congressional leaders on both sides of the aisle, as well as interested groups," Obama transition spokeswoman Stephanie Cutter said. "Any decisions would need to be discussed with his Cabinet nominees, none of whom have been selected yet."

Still, the preelection transition team, comprising mainly lawyers, has positioned the incoming president to move fast on high-priority items without waiting for Congress.

Obama himself has signaled, for example, that he intends to reverse Bush's controversial limit on federal funding of embryonic stem cell research, a decision that scientists say has restrained research into some of the most promising avenues for defeating a wide array of diseases, such as Parkinson's.

Bush's August 2001 decision pleased religious conservatives who have moral objections to the use of cells from days-old human embryos, which are destroyed in the process.

But Rep. Diana DeGette (D-Colo.) said that during Obama's final swing through her state in October, she reminded him that because the restrictions were never included in legislation, Obama "can simply reverse them by executive order." Obama, she said, "was very receptive to that." Opponents of the restrictions have already drafted an executive order he could sign.

The new president is also expected to lift a so-called global gag rule barring international family planning groups that receive U.S. aid from counseling women about the availability of abortion, even in countries where the procedure is legal, said Cecile Richards, the president of Planned Parenthood Federation of America. When Bill Clinton took office in 1993, he rescinded the Reagan-era regulation, known as the Mexico City policy, but Bush reimposed it.

"We have been communicating with his transition staff" almost daily, Richards said. "We expect to see a real change."

While Obama said at a news conference last week that his top priority would be to stimulate the economy and create jobs, his advisers say that focus will not delay key shifts in social and regulatory policies, including some -- such as the embrace of new environmental safeguards -- that Obama has said will have long-term, beneficial impacts on the economy.

The president-elect has said, for example, that he intends to quickly reverse the Bush administration's decision last December to deny California the authority to regulate carbon dioxide emissions from automobiles. "Effectively tackling global warming demands bold and innovative solutions, and given the failure of this administration to act, California should be allowed to pioneer," Obama said in January.

California had sought permission from the Environmental Protection Agency to require that greenhouse gas emissions from vehicles be cut by 30 percent between 2009 and 2016, effectively mandating that cars achieve a fuel economy standard of at least 36 miles per gallon within eight years. Seventeen other states had promised to adopt California's rules, representing in total 45 percent of the nation's automobile market. Environmentalists cheered the California initiative because it would stoke innovation that would potentially benefit the entire country.

"An early move by the Obama administration to sign the California waiver would signal the seriousness of intent to reduce the nation's dependence on foreign oil and build a future for the domestic auto market," said Kevin Knobloch, president of the Union of Concerned Scientists.

Before the election, Obama told others that he favors declaring that carbon dioxide emissions are endangering human welfare, following an EPA task force recommendation last December that Bush and his aides shunned in order to protect the utility and auto industries.

Robert Sussman, who was the EPA's deputy administrator during the Clinton administration and is now overseeing EPA transition planning for Obama, wrote a paper last spring strongly recommending such a finding. Others in the campaign have depicted it as an issue on which Obama is keen to show that politics must not interfere with scientific advice.

Some related reforms embraced by Obama's transition advisers would alter procedures for decision-making on climate issues. A book titled "Change for America," being published next week by the Center for American Progress, an influential liberal think tank, will recommend, for example, that Obama rapidly create a National Energy Council to coordinate all policymaking related to global climate change.

The center's influence with Obama is substantial: It was created by former Clinton White House official John D. Podesta, a co-chairman of the transition effort, and much of its staff has been swept into planning for Obama's first 100 days in office.

The National Energy Council would be a counterpart to the White House National Economic Council that Clinton created in a 1993 executive order.

"It would make sure all the oars are rowing in the right direction" and ensure that climate change policy "gets lots of attention inside the White House," said Daniel J. Weiss, a former Sierra Club official and senior fellow with the Center for American Progress Action Fund.

The center's new book will also urge Obama to sign an executive order requiring that greenhouse gas emissions be considered whenever the federal government examines the environmental impact of its actions under the existing National Environmental Policy Act. Several key members of Obama's transition team have already embraced the idea.

Other early Obama initiatives may address the need for improved food and drug regulation and chart a new course for immigration enforcement, some Obama advisers say. But they add that only a portion of his early efforts will be aimed at undoing Bush initiatives.

Despite enormous pent-up Democratic frustration, Obama and his team realize they must strike a balance between undoing Bush actions and setting their own course, said Winnie Stachelberg, the center's senior vice president for external affairs.

"It took eight years to get into this mess, and it will take a long time to get out of it," she said. "The next administration needs to look ahead. This transition team and the incoming administration gets that in a big way."

Staff writers Juliet Eilperin, Spencer S. Hsu and Carol D. Leonnig and staff researcher Madonna Lebling contributed to this report.

by Michael F. Cannonof the CATO Institute

Which candidate’s health plan will hurt the most?

October 17th, 2008

The basic difference in the major candidates’ proposals for “health care reform,” according to Mark Pauley, writing in Health Affairs, is that McCain recognizes that workers earn their health benefits, while Obama apparently views benefits as the employer’s money (Greg Scandlen, Consumer Power Report 10/16/08).

Obama and supporters claim that the McCain plan will cause workers to lose employer-sponsored insurance, while Obama’s will permit those who like their employer-sponsored plan to keep it.

Summarizing the only two academic studies of the McCain and Obama plans,
John Goodman writes that, according to the Lewin study, 9.4 million would lose employer coverage under McCain, and 13.9 million under Obama. That means for every three people who lose coverage under McCain, four would lose it under Obama. The loss under Obama could be much higher. Employer-based coverage could actually increase with the McCain plan, while dropping by 60 million under Obama, according to the analysis by Roger Feldman of the University of Minnesota.

Obama promised that people buying insurance on their own would have access to the same coverage as members of Congress. The Lewin study assumes that the government-sponsored “national plan,” with the same on-paper benefits, would pay providers 25%, or even 40% less than private plans do.

Medicaid rolls would swell by 16.6 million under Obama, and shrink by 12 million under McCain, as Medicaid enrollees shifted to private plans.

Neither candidate has proposed a realistic way to pay for his proposal. The estimated 10-year cost is $2.1 trillion for McCain and $1.1 trillion for Obama (according to Lewin), and $2 trillion for McCain and $6 trillion for Obama (according to Feldman).

According to an analysis by the Pacific Research Institute (PRI), the McCain plan would help to end job lock, and result in a wage increase averaging $9,000 per year. PRI states that the Obama “job-killing” taxes would be especially harmful to low-income workers, and his reforms would lead to a “death spiral” for privately chosen health insurance (John R. Graham, “Presidential Prescriptions: Diagnosing the Candidates’ Health Reforms, PRI 10/14/08).

The McCain tax credit would correct the “arbitrary, unfair, and wasteful” distribution of tax benefits for health insurance, writes John Goodman. The Obama proposal would “build on today’s regressive, discriminatory subsidies for employment-based insurance,” while new rules would make insurers “little more than functionaries in a new federal government regulatory regime,” states Grace-Marie Turner (Health Care News, September 2008).

Senator Obama seems to be confusing a tax credit with a tax deduction, suggests Ralph Weber, who spoke at the 2008 AAPS annual meeting. A $5,000 tax credit is the equivalent of a $20,000 deduction for most families. It actually is enough to pay the average family health insurance premium in New Mexico, leaving $2,000 to start building up health savings. McCain has also proposed allowing the purchase of health insurance across state lines (FlashReport 10/16/08).

The New England Journal of Medicine shows its political colors in its Oct 16 article, “Primum Non Nocere—the McCain Plan for Health Insecurity.” It concludes that “Senator McCain’s plan does not demonstrate the kind of judgment needed in a potential commander in chief of our health care system”—assuming a “system” that has a commander in chief (David Blumenthal, N Engl J Med 2008;359:1645-1647). For balance, however, Joseph Antos of the American Enterprise Institute writes in an accompanying article that Obama’s “hopes are too audacious to be believed.” A pay-or-play mandate amounts to a tax on labor (N Engl J Med 2008;359:1648-1650).

The “usual suspects show up as savers: health information technology, prevention, and comparative-effectiveness research”- but none is “likely to produce savings any time soon,” Antos writes.

 "And given the closeness of the primaries, it almost certainly made the difference in him getting the nomination. I'm not sure, given the tenor of times, that any Democrat wouldn't have had the advantage in the general election, but certainly the media did nothing to hamper him on the way to the White House."
 
Noyes also expects Obama to have a longer "honeymoon period" with the media than most incoming presidents.

ANCHORAGE, Alaska - Gov. Sarah Palin denounced anonymous criticisms leveled at her by former John McCain aides as lies, including allegations that Republican lawyers were traveling to Alaska to reclaim her high-priced wardrobe and that she didn't know Africa was a continent.(see video clip)