Obama looks to pivot from health care roll-out

McClatchy Washington BureauApril 11, 2014 


President Barack Obama nominates Sylvia Mathews Burwell to head Health and Human Services April 11, 2014 at the White House in Washington, DC. Burwell is the current director of the Office of Management and Budget.


— President Barack Obama worked to turn a page Friday on his signature health care law, nominating White House aide Sylvia Mathews Burwell to replace embattled Kathleen Sebelius as secretary of health and human services.

Known for her management skills, Burwell will become the new face of the Affordable Care Act, a controversial law with a troubled track record that could threaten Democratic prospects in this fall’s congressional elections.

The first test for Burwell will come in the Senate, which unanimously confirmed her as White House budget director last year but which likely will use her confirmation hearings next month to stage a partisan debate over Obamacare.

The hearings could get contentious, as Republican senators seize the opportunity in the run-up to elections to campaign against the health law. But Burwell also could end up looking good by comparison to her predecessor Sebelius, who bore the brunt of the blame for Obamacare’s botched roll-out and glitch-filled website.

“It’s not like she’s going to get a free ride, but she’s got good bona fides, she’s going to be able to answer questions, and honestly, in this nomination, she’s filling the right pair of shoes,” Paul Light, a professor of public service at New York University, said of Burwell. “She’s following a failed leader, and that’s always the easiest act to follow.”

A veteran of Democratic administrations, Burwell is a West Virginia native and a graduate of Harvard University and Oxford University in England, where she was a Rhodes scholar. She has a lengthy record of public service as well as extensive experience in the private sector, where she worked in top jobs at the Walmart Foundation, the Bill & Melinda Gates Foundation and as an associate for the consulting firm McKinsey & Co.

At a White House ceremony Friday announcing Burwell’s nomination, Obama played up her reputation for low-key competence and attention to detail _ skills that could come in handy as she takes over the complex roll-out of the Affordable Care Act.

“Sylvia is a proven manager and she knows how to deliver results,” Obama said.

The president called on the Senate to confirm Burwell without delay.

“Last time she was confirmed unanimously,” he said. “I’m assuming not much has changed since that time.”

It’s true that Burwell is highly regarded by Republicans and Democrats. Both timing and politics will complicate her confirmation process, however. Several states hold primaries in May and June, including some where diehard conservatives are challenging more mainstream Republican incumbents such as Senate Minority Leader Mitch McConnell of Kentucky and Sen. Thad Cochran of Mississippi.

Opposition to the health care law is a major Republican rallying cry this year, so support for Burwell could make the GOP’s incumbents vulnerable to attack.

“That might drive up GOP votes against confirmation but wouldn’t endanger her nomination,” said Sarah Binder, a senior fellow at the Brookings Institution.

One of the reasons Burwell should survive a Senate vote is that it now takes 51 votes to limit debate on nominations, rather than 60, thanks to a Democratic-authored rules change last year.

That change “clears away the key barrier to confirmation,” Binder said.

At least some Republican goodwill toward Burwell was apparent on Friday. Sen. John McCain, R-Ariz., tweeted, “Sylvia Burwell is an excellent choice to be the next HHS secretary.”

Other Republicans indicated they saw her nomination as an opportunity to redouble attacks on the Affordable Care Act. They pledged to continue their fight to repeal or change the law, no matter who was in charge at HHS.

“As I’ve repeatedly said, Obamacare is more than a website. It’s also more than a resignation,” Sen. Roy Blunt, R-Mo., said in a statement. “Secretary Sebelius’ departure doesn’t change the fact that the president’s health care law is fundamentally flawed.”

McConnell said he hoped “this is the start of a candid conversation about Obamacare’s shortcomings and the need to protect Medicare for today’s seniors, their children and their grandchildren.”

Sen. Pat Roberts, R-Kan., who is embroiled in a bitter primary battle with a tea party-backed candidate, serves on two committees with jurisdiction over the health care law and HHS.

He was a family friend of Sebelius, a former governor in his state, and he originally voted to confirm her. But six months ago he became the first senator to call for her to resign.

Roberts’ office didn’t say how the senator planned to vote on Burwell’s nomination, but in a statement Roberts said the appointment of a new secretary would change nothing about Obamacare.

“Obamacare is the president’s legacy,” he said. “The president will unilaterally change what doesn’t work. The march toward socialized medicine will continue.”

Committee hearings are expected to begin on the Burwell nomination in May. Final votes on the Senate floor could come as soon as late May or early June.

Email: lwise@mcclatchydc.com; Twitter: @lindsaywise.

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