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Burwell worked with Kagan on health policy

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Sylvia Mathews Burwell did not write many of the Clinton-era health policy memos now online at the Clinton Library website, but she got the carbon copies.

The library’s searchable online index turns up 26 hits for document files that refer both to “Sylvia Mathews” and “patients’ bill of rights,” and 72 that refer to “Sylvia Mathews” and “health insurance.”

One of the highlights of her appearances in Clinton administration health policy memos came on May 12, 1997, when she advised Elena Kagan about a Partial Birth Abortion Act bill that Sen. Tom Daschle, D-S.D., was about to introduce.

Kagan, who is now a U.S. Supreme Court justice, was a domestic policy advisor at the White House.

Burwell — who added the surname “Burwell” when she married Stephen Burwell in February 2007 — is now President Obama’s nominee to succeed Kathleen Sebelius as secretary of the U.S. Department of Health and Human Services. Burwell was staff director of the National Economic Council from 1993 to 1995; chief of staff to Treasury Secretary Robert Rubin from 1995 to 1997; and deputy chief of staff to President Clinton from 1997 to 1998.

“The First Lady asked Sylvia for a copy of the amendment that Sen. Daschle plans to offer tomorrow,” Kagan writes in a memo amendment to Bill Clinton, at a time when Burwell was Clinton’s chief of staff. “Sylvia suggested that I send it to you too.”

Kagan ended up advising Clinton to support the Daschle amendment, which proposed prohibiting all post-viability abortions except when a pregnancy threatened the life of the mother or appeared to be likely to cause grievous injury.

Earlier, on Jan. 27, 1997, Mathews wrote in a memo to Kagan, “I told Rubin how wonderful you are and the next time you are both in the same place, I will make sure that I introduce you all.”

In February 1997, Kagan and Bruce Reed, who was Clinton’s chief domestic policy advisor, sent Burwell a memo about the status of a variety of ideas for executive action.

Kagan and Reed talked about a wide range of ideas, including extradition of child pornographers, efforts to encourage government hiring of welfare recipients, and a study on ways to increase seat belt use.

Health policy ideas included a ban on human cloning, regulation of tobacco companies’ use of the Internet to advertise tobacco products, strengthening protections for human subjects involved in secret research projects, home health care regulation, and efforts to create a patients’ bill of rights and a health care quality commission.

Kagan and Reed suggested that the White House could announce the members of the new quality commission at the same time that HHS proposed regulations that would guarantee private Medicare plan enrollees access to expedited appeals when plans denied the enrollees access to what the enrollees believed was urgently needed care.

In the home health care regulation section, Kagan and Reed told Burwell a bill might require criminal background checks for home health providers that participated in Medicare.

On June 25, 1999, Dan Mendelson — who is now chief executive officer of Avalere Health and then was associate director for health at the White House Office of Management and Budget — sent Burwell an analysis of a Medicare program solvency proposal. 

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