Provider groups are praising Rep. J. Dennis Hastert (R-Ill.), the House Republicans' likely choice to be the next speaker, as one of Congress' foremost healthcare experts and the GOP's chief consensus-builder on health legislation.
As chairman of the GOP leadership's healthcare task force, Hastert had a hand in shaping the patient-protection legislation that passed the House last year and in Medicare reform measures enacted in 1997.
Provider groups said the 57-year-old suburban Chicago legislator will be able to carry that wealth of healthcare expertise to his new post. Since he already is familiar with their concerns on patient protection and Medicare reforms, he won't need to be brought up to speed on those issues, provider groups said.
"(Hastert) knows the issues, and he understand the players and the twists and turns of it all," said Herb Kuhn, a lobbyist for the American Hospital Association.
"There's no learning curve," said Thomas Scully, president of the Federation of American Health Systems. "He knows as much about healthcare as anybody. I think he has a great understanding of what the politics of healthcare are."
Rep. Bob Livingston (R-La.), who had been the speaker-designate until his dramatic resignation during the debate on impeaching President Clinton, was seen as less of a leader on healthcare issues.
Hastert came to his healthcare leadership role as a member of the House Commerce health subcommittee and as the GOP's chief deputy whip, a role in which he is responsible for securing votes on behalf of top-ranking Republicans.
In those roles, he also has reaped great rewards. Donations from health professionals, insurers, hospitals and nursing homes represented 14% of the $1 million in Hastert's campaign war chest for his 1998 re-election campaign (See Outliers, p. 48).
As speaker, however, Hastert probably would be forced to forgo day-to-day involvement in fashioning healthcare policy. In fact, industry lobbyists said they expect him, unlike outgoing Speaker Newt Gingrich (R-Ga.), to give more policymaking authority to the three committees with jurisdiction over healthcare: Commerce, Ways and Means, and Education and the Workforce.
That is likely to elevate the policymaking role of Rep. William Thomas (R-Calif.), chairman of the Ways and Means health subcommittee.
"I think Hastert is more inclined to regular order and will let Bill Thomas handle things," said lobbyist Randy Fenninger, who works for physician and home health groups.
But whereas Hastert focused on mediating competing views among House Republicans, Thomas tends to take sides and dig in his heels even when challenged by fellow Republicans. That could bring Hastert back into the healthcare fray, one lobbyist said.
"The burden would still fall on Hastert to moderate Thomas," said Sherry Hayes, president of the American Protestant Health Alliance.