As Health & Human Services Secretary, Thompson wields enormous influence over social policy. But he is no longer king. "When I was governor, everyone reported to me," he says. "Now, I have to report to OMB and the White House, and I have 535 bosses on Capitol Hill. It's a big change."
Already, Thompson, 59, is getting a taste of what it's like to be outside the room when the big decisions are made. On Apr. 9, for example, he hinted that the Administration would delay and ultimately change Clinton-era rules regulating the confidentiality of medical records. Three days later, the President announced that the guidelines would be implemented after all, despite fierce opposition from managed-care and pharmaceutical companies.SMOKE ALARM. That's not the first time since Thompson came to Washington that he has been caught flat-footed. He is generally more moderate than the Prez and has deviated from the Administration line on topics ranging from Medicare funding to tobacco regulation. While snagging the nationally prominent Thompson for his Cabinet was a coup for Bush, the two ex-governors could be in for a rocky partnership. "He could show a pragmatic, compassionate side to the Administration, if they would let him," says Senator Russell D. Feingold (D-Wis.), who has known Thompson for nearly two decades.
But Thompson said at a breakfast meeting with reporters recently that he has been told by top White House aides that his opinions "don't matter." On tobacco, which he thinks the feds should regulate, Bush staffers have admonished him to keep his mouth shut. And though he has been an avid supporter of stem-cell research, Thompson recently signaled that the Administration may ultimately side with anti-abortionists seeking to prohibit federal funding for studies involving human embryos.
On other issues, though, Thompson continues to speak his mind. To reduce the number of Americans without health insurance, Thompson favors the Democratic approach of expanding the Children's Health Insurance Program. The Administration wants to provide tax credits instead, so individuals can buy their own health insurance.
Thompson also broke ranks with the President over accounting for Medicare funding. When the White House suggested diverting some of the surplus in the Medicare trust fund to finance tax cuts and other spending, he testified against the idea before the House Ways & Means Committee. The next time a hearing on the subject rolled around, Thompson was absent. "I've already been in the doghouse," he acknowledges.ACID TEST. That isn't to say Thompson has lost his clout. For example, he will play a pivotal role when the 1996 welfare-to-work act comes up for reauthorization next year. Welfare could be an acid test for the Administration: If the economy continues to stumble and layoffs rise, the durability of the welfare reform "miracle" could be severely tested.
Revamping public assistance is Thompson's signature issue. Under his leadership, Wisconsin was one of the first states to institute work requirements, though it softened the blow by also providing child care, job training, and transportation. Wisconsin's welfare rolls plummeted, and Thompson's credibility on the issue could make him a powerful emissary to Republicans who are gunning for the block grants parceled out to the states. "He's going to help shape the consensus on welfare," says Donna E. Shalala, HHS Secretary under President Clinton.
Indeed, it was Thompson's record of innovation in social services that made him an obvious fit for HHS. Oddly enough, his first choice was Transportation Secretary. He has been chairman of Amtrak, the quasi-governmental passenger railroad company, since 1999. Thompson enjoys the job so much that he refuses to step down so Transportation Secretary Norman Y. Mineta can take his seat. "The President will make the final call," Thompson says. "And I am arguing my case vociferously."
With his progressive instincts and charismatic persona, Thompson will face many more substantive debates in the months ahead. "The question about the Bush Administration is: `Will they hire smart people and let them do their jobs?"' asks University of Wisconsin political science professor Donald F. Kettl. "Or are they going to demand total loyalty?" Another question might be: In this right-of-center, stay-on-message Administration, how long can an outspoken, compassionate conservative last? By Alexandra Starr in Washington