Officials facing tricky prospect: How do you disagree with the first lady?

January 28, 1993|By Susan Baer | Susan Baer,Washington Bureau

WASHINGTON -- It's the sort of question Emily Post never had to face: How do you politely disagree with the president's top adviser on health care reform when she's also the president's wife?

But legislators, lobbyists and aides realized this week that such a point of protocol was one of many new questions they'd have to grapple with as President Clinton appointed first lady Hillary Rodham Clinton to head a national health care reform task force.

Perhaps nothing jolted official Washington more into the reality that this first lady will be like no other than word of Mrs. Clinton making the Rolodex rounds this week, chatting up the likes Rep. Dan Rostenkowski of Illinois. And Sen. Donald W. Riegle Jr. of Michigan. And West Virginia Sen. John D. Rockefeller IV. And California Rep. Pete Stark, who was host at a dinner for the House Ways and Means health subcommittee -- plus Secretary of Health and Human Services Donna Shalala -- when the first lady rang him at home.

"Courtesy calls," they were termed by those on the receiving end.

"Wake-up calls" may have been more like it.

Many involved in the health care issue heralded Mrs. Clinton's appointment, saying it reflected the president's commitment to health care reform and ensured priority treatment.

"Hallelujah," said Mr. Rockefeller, who advised the Clinton transition team on health care matters.

But at the same time, many legislators, aides and lobbyists have been questioning whether the ground-breaking move of having a first lady in a key policy-making position won't be tricky business for them and risky business for the president.

"Hillary's a whole new game," said one Democratic Hill aide. "People are uneasy about it."

Monday's appointment of Mrs. Clinton to chair an interagency task force that will formulate the health care policy the president sends to Congress merely makes official what the public suspected -- but what the Clinton team tried to soft-pedal -- during the campaign: that Mrs. Clinton will be her husband's most important policy adviser.

Maryland Rep. Benjamin L. Cardin, a member of the House Ways and Means health subcommittee, vigorously applauded the appointment, saying that it not only elevates the profile and priority of health care reform, but also "elevates the stakes in making sure it comes out successfully."

But he also pointed to potential pitfalls. "You do have an immediate problem. She's taking on a major area of responsibility, but she's also the first lady of the nation. You have to be able to give her your frank, open views on what's transpiring, but it will be difficult because of her other role."

Indeed, many echoed the concern that a first lady at the table could inhibit free-wheeling discussion and challenges.

"The ladies and gentlemen of government are going to be asked to perform a diplomatic task unlike anything they've ever done before," said Robert Moffit, deputy director for domestic policy at the conservative Heritage Foundation. "They have to ask tough questions of Mrs. Clinton if they're going to do their job. If they are intimidated, she will not be properly served."

Gary Bauer, domestic policy adviser in the Reagan White House, said he encountered such problems when administration officials shied away from getting involved in any issue in which Nancy Reagan had a hand.

"I don't see how a Cabinet secretary will dare to challenge a first lady on a policy proposal," Mr. Bauer said. "My reading of human nature is that one is not going to criticize lightly the person the president is going to turn in with that night."

Similarly, some have questioned an official's ability -- or propensity -- to go to the president and say, "This is not working out," if things aren't.

Although the first lady is not an expert on health care issues, many in the health care industry have great confidence in her, especially her ability to get things done. In Arkansas, Mrs. Clinton was appointed by her husband to a similar role as head of an education reform commission. There, she held hearings, developed policy and ultimately sold her plan to the state legislature which repaid her with a standing ovation.

Of course, part of Mrs. Clinton's ability to whip people into fast action -- then as now -- is her first lady status.

"When Hillary Clinton wants something done -- whether it's research or analyses -- it will get done," said Mr. Moffit, a former deputy assistant secretary of health and human services. "Disobedience here carries with it career-changing possibilities. She'll be able to cut through a lot of red tape."

Lobbyists say they, too, have been pondering this new twist in the policy making process. "It's going to be hard to know how to lobby the first lady," said Sara Nichols, a health care lobbyist for Public Citizen's Congress Watch.

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