"I think this is a strong commitment that exists throughout the administration, starting with the president," Pollack said.
But Lew clearly brings particular intensity to the issue. He shouted down an effort to cut Medicaid in one meeting with congressional Republicans, a break from his normally reserved style.
"Republicans came back and wanted one last shot at Medicaid. And Jack — who is known throughout Washington as a thoughtful, gentle person, really got angry at that, and expressed his anger. And that was the end of the subject," Pollack said. "So this is something, I think, for Jack, that combines his commitment in the head as well as the heart."
Medicaid is exempt from the automatic spending cuts now delayed until March, though those cuts include an across-the-board reduction in Medicare payments. And the White House has said it no longer supports a proposal to change the way the federal government calculates its share of Medicaid payments, which ultimately would have put a greater burden on state budgets.