Merger talks put a CEO’s diplomatic skills to test

Insurers are “a positive force for both quality and [reducing] cost,’’ Roosevelt said afterward. “So to be the designated villain was an uncomfortable place to be. Now politically, I understand why that happened. But that doesn’t help your emotional reaction.’’

The man chosen to run the health insurance giant that would arise out of this week’s proposed merger of Tufts Health Plan and Harvard Pilgrim Health Care is not often rattled. With his patrician roots and strong diplomatic skills, Roosevelt, 65, has frequently been tapped by political and business leaders to deliver an unwelcome message or fix a thorny problem. Now those skills will be put to the test as he spearheads a merger push that is certain to be scrutinized by regulators and consumer advocates.

Roosevelt is a health policy insider and behind-the-scenes force in Democratic circles. He is also a lawyer, grandson of Franklin Delano Roosevelt, a guy who prefers diners and neighborhood restaurants over trendy bistros, and a devout Catholic who distributes Communion on Sundays at his church in Cambridge.

Since 2005, he has led Watertown-based Tufts, the state’s third-largest health insurer. A familiar figure in Boston, he is equally at home in Washington, D.C., where he was a top official in the Social Security Administration during the Clinton years.

“He’s very comfortable in difficult situations,’’ said Dr. Frank LoGerfo, former chairman of surgery at Beth Israel Deaconess Medical Center in Boston and a longtime friend and Cambridge neighbor of Roosevelt. The two men and their wives often dine together at Greg’s Restaurant in Watertown, talking about everything from their children to the foibles of the players in the local health care business.

“A lot of people in these kinds of jobs are stuffed-up and standoffish,’’ LoGerfo said. “But he’s very down to earth.’’

Jeanette G. Clough, president of Mount Auburn Hospital in Cambridge, where Roosevelt once was board chairman, recalled how easily he mixed with members of the Thai royal family at a Mount Auburn-sponsored event several years ago. “He was talking to princes and royals as he would talk to our employees,’’ Clough said. “His ability to relate to people in all walks of life is part of his charm.’’

Roosevelt, who is chief executive of Tufts, declined to be interviewed for this story, suggesting through a company spokeswoman that he wanted to avoid the spotlight while Tufts and Harvard Pilgrim work to reach a definitive agreement.

Indeed, he often is more comfortable working outside the public view. Party officials asked Roosevelt, cochairman of the national Democratic Party’s rules and bylaws committee, to mediate a 2008 standoff between candidates Barack Obama and Hillary Clinton over seating disputed convention delegations from Florida and Michigan.

At the White House reception for health insurance chief executives last year, he was the one to pose a polite but pointed question to Obama, who had used insurers as a rhetorical punching bag in the health care debate. Roosevelt, an Obama supporter who served on his transition team, asked if the president thought vilifying insurers was the best way to persuade them to help implement changes in the nation’s medical care system.

Roosevelt has taken a lower profile in some of the state’s health care dust-ups, leaving it to his trade group, the Massachusetts Association of Health Plans, to speak out, for instance, against Governor Deval Patrick’s premium rate caps last year on health insurance policies for small businesses and individuals.

While he is popular among members of the health care industry establishment, a 1986 foray into elective politics was less successful. He lost a Democratic primary race for Congress to Joseph P. Kennedy II in the state’s Eighth Congressional District.

Perhaps the biggest surprise of Roosevelt’s career came Tuesday. With most state health care leaders focused on Patrick’s anticipated legislation to change the way care is paid for, Roosevelt shocked the industry by signing a memorandum of understanding to merge with Wellesley-based Harvard Pilgrim, the state’s second-largest health plan. If the deal happens, it would shake up the state’s health insurance business by reducing the number of big insurers from three to two and creating a more formidable rival to the market leader, Blue Cross Blue Shield of Massachusetts.

As the merger is now envisioned, Roosevelt would serve as chief executive for the first two years, overseeing a company serving 1.7 million members in four New England states. After that, he would become executive chairman, turning over the chief executive’s reins to Eric H. Schultz, Harvard Pilgrim’s chief.

Speaking shortly after signing the memo of understanding with Schultz, 51, and meeting with his employees, Roosevelt defended the deal against criticism it could lessen competition. He said the goal is to create a health insurance company that has enough clout to bargain with hospitals and doctors for lower rates, as well as the resources to support performance-based programs that will improve medical care and lower costs for patients.

“The fact that these two plans coming together are still smaller than Blue Cross means you’ll have more competition,’’ he said.

Boston political consultant Philip W. Johnston, former chairman of the Massachusetts Democratic Party — for which Roosevelt has long volunteered as general counsel and convention parliamentarian — said the Tufts chief executive is motivated more by public policy and social justice than by business concerns. A strong backer of the changes in state and federal health care, Roosevelt is especially interested in expanding access to health care for the poor and building economic security for middle-class workers, Johnston said.

“He’s in the social justice tradition of his grandfather,’’ he said. “That’s what drives him. His grandfather created Social Security, and he was one of the principals in running it 50 years later.’’

Noting that Tufts and other big insurers in Massachusetts are nonprofits, Johnston said they have attracted executives more driven to expand health care access than to increase profits. “You’re not talking about for-profit, predatory insurance companies,’’ he said. “They’re all committed to the notion that every citizen deserves affordable health care. Jim is very much a leader in that tradition.’’

Mount Auburn’s Clough, who worries that a larger insurer might take a harder line in rate negotiations with hospitals and other health care providers, nonetheless said she believes Roosevelt is someone who will consider both sides of the issue.

“He’s always had the ability to see both the providers’ perspective and the payers’ perspective,’’ she said. “You’re talking about a man with a 360-degree view of health care.’’

Robert Weisman can be reached at weisman@globe.com.