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Dan Diamond, Managing Editor
President Obama will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace Kathleen Sebelius as head of HHS.
Sebelius offered the president her resignation this week and will step down on Friday. The current HHS secretary has been criticized for months by Republicans, who suggested that she should bear responsibility for last year's failed launch of the federal insurance exchange website.
GOP leaders call for Sebelius' resignation. Is her job at risk?
Who's Burwell? Meet the nominee
As HHS nominee, Burwell is a "relative outsider," the New York Times notes, although she has run OMB—which has played a role in setting national health policy—since last April, and served as the agency's deputy director for three years in the late 1990s. In that earlier role, she was known for "butting heads" with Republicans in negotiations over President Clinton's budget.
Before joining the Clinton administration, Burwell gained some private-sector experience as a McKinsey consultant. And after leaving the Clinton administration—but before returning to politics—she cultivated experience in the foundation world, having spent a dozen years doing philanthropic work:
- 2001-2011: Executive-level positions at the Bill and Melinda Gates Foundation
- 2011-2013: President of the Wal-Mart Foundation
Burwell's track record in health care is not well-established, although she previously served as a board member of the University of Washington Medical Center. Burwell also hinted at some of her health care views in her Senate confirmation hearings last year, touting the value of electronic health records—specifically, their positive impact on "quality of care and cost savings"—and her hesitation when Republican senators asked her if Medicare needed major reforms.
What the administration hopes Burwell will bring
According to the Times, administration officials hope Burwell will bring "an intense focus and management acumen" to HHS, which has been heavily scrutinized since the bumpy launch of HealthCare.gov.
And while the first open enrollment period for the ACA's insurance exchanges may be over, HHS faces continued challenges implementing the health law this year, ranging from questions over how to apply the law's mandate penalties to the politically sensitive issues related to premium costs.
'Obamacare' is more than the exchanges: Three other areas of focus
Republicans also have focused considerable attention on Sebelius—who in closely watched hearings on Capitol Hill last fall, said she accepted responsibility for the insurance exchange rollout "debacle"—and some officials suggested that having a fresh face in the role of HHS secretary may ease political deal-making around ongoing implementation of the Affordable Care Act.
To that end, the administration may have considered that Burwell breezed through Senate confirmation last year in a 96-0 vote. (In contrast, Sebelius was confirmed in a 65-31 vote for HHS secretary, although the process for health care-related appointments historically has been more politically contentious.)
"Sylvia has spent a career fighting for working families, and she was part of an OMB team that presided over three budget surpluses in a row," Obama said in a statement after Burwell was confirmed as OMB director last April. "Sylvia will be a key member of my economic team, and I look forward to working with her in the years ahead."
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Daily roundup: April 10, 2014