Hillary Clinton worked to get a high-dollar donor to the Clinton Foundation access to a top White House health care official during the legislative fight over Obamacare, according to emails that reveal new details about the administration’s role in that fight.
An administration official regularly briefed Clinton on the status of Obamacare legislation, the emails show. Some of those messages reveal concerns about the law’s unpopularity, its price tag, and its inability to control health care costs that the administration publicly dismissed or downplayed.
In June 2009, Clinton emailed Neera Tanden, a former Clinton campaign operative, then a top aide to Health and Human Services Secretary Kathleen Sebelius, and now the president of the Center for American Progress.
Clinton wanted Tanden to arrange a meeting between three doctors and Nancy Ann DeParle, the White House official leading its health care reform efforts.
"I can arrange it, no worries," Tanden assured her. "I know Dean Ornish from the Obama campaign," Tanden said, referring to one of the trio.
Ornish is a high-dollar Democratic donor. According to federal campaign finance records, he’s given more than $700,000 to Democratic campaigns, party organs, and outside groups since the 1990s.
His organization, the Preventive Medicine Research Institute, previously received $3.5 million in earmarks courtesy of then-House Majority Leader Nancy Pelosi (D., Calif.), one of the recipients of his political contributions.
Ornish has donated to both of Clinton’s presidential campaigns, and co-hosted a fundraiser for the campaign in 2007. He is also a high-dollar donor to the Clinton Foundation, having given between $100,000 and $250,000, according to the Foundation’s website.
Tanden apparently arranged the meeting between Ornish and DeParle. "Thanks for following thru," Clinton wrote five days later.
That exchange was one of many between Clinton and Tanden during the legislative battles over Obamacare, according to emails to Clinton’s personal email address released by the State Department in response to a series of Freedom of Information Act requests.
The emails show Tanden providing frequent updates from the White House’s perspective on those fights, often sharing details that contradicted administration talking points about the promised benefits of their health care reform efforts.
One selling point for the law was that it would reduce health care costs. But as early as October 2009, six months before Obamacare became law, Tanden cast doubt on its cost-control measures in private exchanges with Clinton.
"In terms of cost controls, the dirty little secret is that we don't have a lot of good evidence on what works—in a way that that Congress has any appetite to do," Tanden wrote in one email.
"I mean, cost controls, as we all know, is attacked as rationing. So everyone likes to discuss this, including the Administration, but then on the other hand, says they won't touch benefits," she complained.
Republicans frequently attacked provisions of the bill as efforts to "ration" health care, such as its creation of Medicare’s Independent Payment Advisory Board, which makes recommendations about medical care that should or should not be covered by the entitlement program.
Though the administration publicly denied that IPAB would limit care, Tanden conceded in an email to Clinton that its purpose was "to streamline cutting Medicare." Other cost control mechanisms would also target the program, Tanden said. "We'd use mostly Medicare Advantage cuts" to pay for another portion of the bill, she wrote.
Despite those efforts, Tanden admitted that she was not convinced the law could actually "bend the cost curve," as the administration claimed.
"By emphasizing costs so much at the beginning of this process, we may have oversold what these bills will (or even can) do," she admitted to Clinton.
Tanden also conceded that the American people did not look fondly on Obamacare in its legislative stages. "There is a lot of anger at the White House [at Democrats in congress] for making them spend a year on this bill that is so clearly unpopular," she told Clinton.
"Everyone is freaked out," she wrote. "Polling is horrible out there."
Despite those concerns, Tanden was determined to make sure that Clinton got credit for the law.
The day Obamacare passed, Tanden emailed Clinton with the subject line "Thank you." "I know – maybe more than most – how much the President's actions over the last year were influenced by the primary fight on health care," she wrote.
Two months later, after Tanden had joined CAP, she was pitching reporters on stories that would ensure Clinton earned credit for the law.
"I'm meeting with Robert Pear on Friday to pitch him on how so many of your ideas are in the health care bill and it is closest to your proposal," she told Clinton in May 2010. "I've held out for him, but if he doesn't I can go to the Post or elsewhere."
After the Supreme Court upheld the individual mandate in 2012, Tanden touted CAP’s efforts to preserve the measure. "I've been working to defend the mandate for 4 years in honor of 2007/2008," she wrote.
Neither the Clinton campaign nor Tanden returned a request for comment.