The Senate today confirmed Sylvia Mathews Burwell as the next secretary of the US Department of Health and Human Services (HHS) in a 78 to 17 vote that shows how her job of implementing the Affordable Care Act (ACA) will not be easy.
Although the vote was overwhelmingly in Burwell’s favor, she had received unanimous approval — 96 to 0 — when the Senate confirmed her in 2013 as the director of the White House Office of Management and Budget (OMB). Last year’s bipartisanship, however, dissolved today as a cadre of Republican senators used her nomination by President Barack Obama as another opportunity to blast the ACA and anybody who supports it.
“I’ll be voting against this nominee, because I think we need to focus on repealing and replacing this law, not trying to do the impossible by pretending we can make it work,” said Senate Republican Leader Mitch McConnell (R-KY) on the Senate floor today. “Her embrace of this disastrous law is reason enough to oppose her confirmation.”
Obama nominated Burwell to replace Kathleen Sebelius, who oversaw the massive department and its nearly $1 trillion budget since 2009, but resigned in the wake of the botched roll-out of the Healthcare.gov Web site. The Web site was intended to help millions of Americans obtain healthcare coverage beginning in 2014 through state insurance marketplaces, or exchanges, but computer glitches galore deterred many of the applicants initially.
During Sebelius’ final months, HHS got the Web site in better working order, helping to boost exchange plan enrollment to 8 million, exceeding the administration’s expectations.
Praised as a “proven manager who knows how to deliver results” by the president, Burwell inherits the task of keeping the ACA on track and out of bad headlines. Any misstep is liable to become a campaign issue in the November elections, when Republicans hope to regain control of the Senate.
One immediate challenge for Burwell is cajoling health insurers in the state exchanges to settle for modest premium increases in 2015 so coverage remains affordable. Another pitfall to navigate is the possibility of mass cancellations of small-group health policies as they come up for renewal this fall. A number of states will not allow policy holders to renew plans that fail to meet ACA standards.
“A True Agent of Bipartisanship”
Burwell has gone through political storms before. She was President Bill Clinton’s deputy chief of staff during the Monica Lewinsky scandal.
Her track record during the Clinton administration also includes stints as deputy director of the OMB, chief of staff to former Treasury Secretary Robert Rubin, and staff director of the National Economic Council. Before she became OMB director last year, a role that hurled her into Capitol Hill’s acrimonious budget wars, Burwell served as president of the Walmart Foundation and president of the Global Development Program of the Bill & Melinda Gates Foundation.
Before today’s confirmation vote, Sen. Ron Wyden (D-OR), chair of the powerful Senate Finance Committee, said that the country needs a “true agent of bipartisanship” at HHS, and Burwell fits the bill.
“She will respond to the big questions and the big challenges in a way that brings America together,” said Wyden.