When Gail Wilensky talks, conservative lawmakers listen. From positions in the first Bush administration to advocate of congressional Republican Medicare reform plans, Wilensky is the broker who makes a compelling case for market-based restructuring of government-run health plans.
HCFA administrator and White House healthcare policy adviser under former President George Bush, Wilensky found herself thrust back into a policymaking role when Republicans assumed control of Congress in 1995.
First appointed chairwoman of the Physician Payment Review Commission in 1995, she went on the road to promote the Republican lawmakers' balanced-budget plans in 1995, which included significant restructuring of Medicare through greater reliance on private-sector health plans.
After passage of the 1997 balanced-budget law, she became chairwoman of the Medicare Payment Advisory Commission, which was created under the law through a merger of the PPRC with the former Prospective Payment Assessment Commission.
Wilensky is the voice Republican lawmakers have turned to during their stint in the majority when looking for strong policy arguments in favor of market-based reforms. Yet she has angered some congressional allies.
Though supporting market-based Medicare reforms, she has said the public won't be ready until there's a crisis, which some Republican leaders saw as undercutting their plans for Medicare. And when MedPAC backed a generous increase in Medicare payment rates in 2000, Rep. William Thomas (R-Calif.), then chairman of the House Ways and Means health subcommittee, suggested that the panel was an "organized forum for the voice of self-interested lobbying."
Although she was removed from the MedPAC chairmanship earlier this year and has resigned from the panel, Wilensky recently was named co-chair of a committee to study veterans' healthcare.