Official portrait of United States Health and ...

Few noticed but at last week’s Rose Garden announcement by the president that his administration’s signature healthcare initiative had exceeded his 7 million signups goal by the end of March, he failed to mention Kathleen Sebelius’ name even though she was sitting right in front of him. On Thursday Sebelius made it official: she was leaving her post as head of and Human Services.

More than a month earlier Sebelius had approached the president to discuss her future now that the worst of the signup fiasco appeared to be behind her. Publicly the president had been supportive of her ever since he nominated her to the head of and Human Services at the start of his first administration. Privately however he was furious over the botched roll-out, and according to White House aides, blamed Sebelius for most of it.

It was time for a change as the president’s concerns continued to grow about the damage his signature legislative achievement is likely to do to his administration’s legacy, not to mention the fallout likely in November as Americans increasingly discover the real costs of the program hitting their wallets.

Sebelius was the fair-haired child when he nominated her to head up HHS in 2009. Daughter of a former Ohio Democrat governor, she moved to Kansas in 1974 where she learned the political ropes early. She was elected to the House of Representatives in 1986 and won three more reelections despite her pro-abortion, anti-gun stances. She even overcame being sullied by revelations that she had received substantial campaign contributions from notorious abortionist George Tiller who was later gunned down in the narthex of his church.

Politically she made all the right moves, serving as Kansas’ governor from 2003 to 2009, resulting in the New York Times citing her to be among the women most likely to become the first female president of the United States.

After announcing her support for Barack Obama over Hillary Clinton during the president’s first run for the White House and then delivering the Kansas delegation for him, it was an easy choice for the president to make once he was in office.

She was determined in her support of especially during the darkest days last year as the program looked likely to be stillborn. In October she took the blame for the rollout problems, shielding her president as best she could:

You deserve better. I apologize. I’m accountable to you for fixing these problems and I’m committed to earning your confidence back by fixing the site.

On Friday the president nominated her replacement, Sylvia Mathews Burwell, his current Director of the Office of Management and Budget (OMB). Burwell, with an insider’s typical pedigree – degrees from Harvard as well as Oxford where she was a Rhodes Scholar – is expected to meet little if any during confirmation hearings in the Senate for her new position. She worked as a governor’s aide to Massachusetts Governor Michael Dukakis as well as both the Dukakis/Bentsen and Clinton/Gore presidential campaigns. She served as Deputy Chief of Staff for President Bill Clinton for two years and then moved up to Chief of Staff to Clinton’s Treasury Secretary Robert Rubin. When the president nominated her to head up the OMB, the Senate ratified her nomination 96-0.

The president’s Chief of Staff Denis McDonough said she was selected because she is “a proven manager and [a] relentless implementer.” With all the problems awaiting her, Burwell will need every ounce of dedication and determination she can muster to implement the greatly flawed program. She faces questions on how to implement the parts of that the president unilaterally delayed into the future, including the mandate that requires employers to provide insurance to their workers. There will be higher premiums to be announced over the summer by insurers who will be forced to rework their numbers based upon the real world enrollment numbers instead of those fabricated by the administration at the beginning. There is the new vendor behind the website, Accenture. There are the changes being made by several states to improve their exchanges’ performance. There’s the question of how to enforce the extraction of penalties from those recalcitrants who have failed to sign up voluntarily for the program. And so on.

She is getting plaudits from the usual suspects, including Timothy Jost, a supporter and professor at Washington and Lee University who said

It’s good that Secretary Sebelius is able to resign at a time when implementation is going rather well rather than during the dark days of last fall when success seemed far from certain.

Mrs. Burwell seems well-positioned to move implementation forward.

One of the very first challenges Burwell will face as the new head of HHS is how to boost real fully-paid enrollments among those for whom the program was allegedly designed to help the most: those without coverage. Following the president’s triumphal announcement last week that his ACA enrolled more than 7.5 million people by the March 31 deadline, Burwell will shortly discover the lie in those numbers.

McKinsey, the country’s leading management consulting firm, reported that there is a big difference between “enrolled” and “paid”. It now appears, based upon its latest survey, that fewer than a million previously uninsured have actually signed up and paid for coverage under ObamaCare, even after having their premiums subsidized by other taxpayers.

When Reince Priebus, chairman of the Republican National Committee, learned that Sebelius had resigned and that Burwell was going to be nominated to fill her slot, he spoke for many:

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, will continue to be a disaster and will continue to hurt hardworking Americans.


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