When Health and Human Services Secretary Kathleen Sebelius leaves her post at the end of next month, her successor will immediately confront a host of challenges associated with the Affordable Care Act, dealing with both politics and policy.
President Obama acknowledged as much on Friday, when he announced that he was nominating Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace Sebelius.
“We know there’s still more work to do at HHS,” he said. “There’s more work to do to implement the Affordable Care Act. There’s another enrollment period coming up about six months from now. There’s whole array of responsibilities to meet over at this large and very important agency.”
Before she can dive into the policy issues, Burwell will have to make it through the political hoops that Republicans are sure to set up for her confirmation process in the Senate. That, however, is just the beginning. Once she’s actually leading HHS, she’ll have to help the agency finish the back-end computer programs to keep HealthCare.gov running smoothly, help it enforce the new “individual mandate” penalty, and prepare to enact the controversial “employer mandate” — all within in an election year.
Sen. Charles Grassley, R-Iowa, gave a blunt assessment of the challenges ahead when it was reported Thursday that Sebelius would resign: “Anybody put in charge of Obamacare would be set up to fail. Secretary Sebelius was asked to promote something unready, poorly structured, and unpopular… The next secretary might have a fresh start with the public and Congress but the flawed law is still the law.”
While other presidential nominees have had trouble making it through the Senate, Burwell’s nomination is likely to go through — if only because the Senate late last year changed the rules so that a minority could no longer use a filibuster to block the confirmation of executive branch nominees.
Furthermore, at least one Senate Republican has already given his nod of approval to the nomination: “Sylvia Burwell is an excellent choice to be the next #HHS Secretary,” Sen. John McCain, R-Ariz., said on Twitter.
White House spokesman Jay Carney on Friday refused to even entertain speculation that her nomination could stall in the Senate, given that Burwell was confirmed by a vote of 96 to 0 last year to head the OMB.
Still, Republicans have made it clear they won’t pass by this midterm election-year opportunity to highlight all of the Affordable Care Act’s problems.
“Secretary Sebelius oversaw a disastrous rollout of ObamaCare, but anyone can see that there are more problems on the way,” Republican National Committee chairman Reince Priebus said in a statement. “The next HHS Secretary will inherit a mess–Americans facing rising costs, families losing their doctors, and an economy weighed down by intrusive regulations. No matter who is in charge of HHS, ObamaCare will continue to be a disaster and will continue to hurt hardworking Americans.