You may not have heard the name Peter Harbage before. But if you are one of the millions of people getting health insurance because of Obamacare or some other government program, it's possible Peter had something to do with it.
Peter was a health policy analyst, advocate, and consultant who spent most of his professional life shuttling between Washington and Sacramento, California -- at times working for the government, at other times working with it. To reporters covering health policy, such as myself, he was a source and, yes, a friend -- a reliably honest source of information and expertise, and unfailingly good cheer.
Earlier this month, Peter lost a battle to leukemia. He was 43 and had been married, for a little more than five years to Hilary Haycock, a veteran health policy and public affairs expert.
Peter's eclectic legacy includes running with the bulls in Spain and a drink named for him at The Grange, an upscale restaurant frequented by California pols in Sacramento. But it was Peter's advocacy for health care reform -- particularly his success at rallying people and groups behind the cause of expanding access -- that left the most indelible impression in political circles.
"He was a man of passion who was dedicated to the cause," says Chris Jennings, the former Clinton administration official and well-known advocate for health care reform in Washington. "He so wanted to made a difference and he did not rest until he did."
"Peter is the unsung architect of health care reform in the United States," says Anthony Wright, executive director of Health Access, a California-based advocacy group. "For two decades, Peter has been on the front lines of the work to improve our health system, as an administrator, consultant, policy guru; as an evangelist, a thinker and a provider of social lubricant."
Peter got his start in health policy in the 1990s, after graduating from the University of Michigan with a bachelor's degree and a master's in public policy. He had taken a position at the Department of Health and Human Services when, during a meeting about a new initiative, he impressed Nancy Ann Deparle -- who was, at the time, the Clinton administration's newly confirmed administrator for the Medicare and Medicaid programs.
"The room was filled with probably 50 or 60 staffers representing the staff and operating divisions of the department, and they were all peppering me with questions about implementation," DeParle recalls. "I noticed this one young man who kept asking very good questions, and sometimes helping me answer others' questions. I knew right then and there I wanted him on my team."
Later, Peter's trajectory took him to California, where he worked in the administration of Gov. Gray Davis and, then, joined the crusade to create a version of universal health care while Arnold Schwarzenegger was governor. That effort came up just short, but a parallel effort, in Massachusetts, succeeded -- thus establishing a program that would become the model for Obamacare.
Peter played a key role in that evolution -- thanks to an episode that history has largely, and wrongly, forgotten. Early in the 2008 presidential campaign cycle, Peter was working on the campaign staff of then-Sen. John Edwards, whom he had also advised in 2004. Within the inner circle of advisers, Peter was among those urging Edwards to propose an ambitious plan that would seek to make coverage nearly universal. Edwards would go on to lose the primary campaign and, subsequently, to disgrace himself with a personal scandal. But Edwards' early embrace of such a sweeping health care plan, including a requirement that everybody get coverage, set the standard by which other candidates would be judged -- making universal coverage, or something close to it, a prerequisite for serious consideration in the race.
"Peter was John Edwards' principal adviser on health policy for six years, including both of his White House campaigns," says James Kvaal, who was policy director in the 2008 campaign and now works in the Obama administration. "His fingerprints were all over Edwards' plan for universal health care, the first from a presidential candidate in over 15 years."
After Obama's election, Peter worked on reform from the outside -- helping to rally interest groups behind what eventually became the Affordable Care Act. He understood, more than most people, that simply passing legislation was only step one -- and started working closely with local and state officials, with a focus on programs that would help low-income Californians get access to care.
"Peter Harbage has improved the lives of countless people through his generosity as a friend, advisor and policymaker," Mari Cantwell, chief deputy director at California's Department of Health Care Services, told the California HealthLine. "He was intelligent and passionate about our work to improve and expand health care to Californians in need, and we are grateful that he shared his time and knowledge with us."
Peter was in the midst of his California work when he got the leukemia diagnosis. He remained an incorrigible optimist, finding an upside even in such a dire personal moment -- suggesting to me, at one point, that he thought his experiences as a cancer patient would make for a good book. His treatment seemed to be going well, when, a few weeks ago, he took a sudden turn for the worse.
"He quietly took his battle against leukemia head-on and seemed to be winning it as he did with virtually all challenges he confronted," says Jennings. "But this time, he could not overcome an infection and we all learned what is all too hard to accept -- we all eventually fail in the battle against death. The good news is that Peter won the battle of life and we are all the better for it."
"Peter's work in health care was deeply driven by a sense of fairness and a fight against the idea that somehow it's acceptable to have 'two Americas' -- one where care is available and one where it is not," says Haycock, who will remain at the helm of Harbage Consulting. "He spent his career supporting the safety net and those who need it, and helping to level the playing field for Medicaid."
Peter set aside starting funds for a new fellowship, to pay for recent graduates in health policy to spend time working with advocacy and education groups in California. Information about the fellowship, and how to support it financially, is available at the Harbage Consulting website.