President Barack Obama announced Friday that he will nominate his budget director, Sylvia Mathews Burwell, as the new secretary of health and human services, replacing former Secretary Kathleen Sebelius, whose resignation was reported Thursday.
"Under Kathleen's leadership, her team at HHS turned the corner, got it fixed, got the job done," Obama said in a Rose Garden ceremony Friday morning. "And the final score speaks for itself."
The moves come just over a week after the open enrollment sign-up period closed for the first year of insurance coverage under the Affordable Care Act, widely referred to as Obamacare. Over the past several months, Sebelius had fielded attacks from conservatives and critics of the law, particularly over the rollout of the HealthCare.gov website.
As for Sebelius’ replacement, during the White House ceremony Obama praised Burwell — who also worked in the Clinton administration, for the Bill & Melinda Gates Foundation and the Wal-Mart Foundation — for her management skills and her help guiding the administration through a 16-day government shutdown last fall.
"Sylvia was a rock, a steady hand on the wheel who helped navigate the country through a very challenging time," he said.
Those who have worked with Burwell describe her as meticulous, driven and results-oriented. Neera Tanden, who worked in the Clinton and Obama administrations, told The Associated Press that Burwell also helped blaze a path for women in the policy world through her confidence and hard work.
In selecting Burwell to replace Sebelius, Obama chose a veteran technocrat who members of both parties say is up to the challenge of running a $1 trillion bureaucracy that rivals the Pentagon in complexity. If confirmed, she'll inherit a beleaguered agency characterized by the shaky rollout of the health care law and HealthCare.gov.
Although the Senate confirmed her unanimously for her current job, Burwell is unlikely to emerge without a few bruises. With an eye toward the midterm elections, Republicans are eager to re-litigate Obama's health care law in every public setting possible — and a Senate confirmation hearing offers a prime opportunity.
Part of persistent criticisms of Obamacare included the widespread belief that the administration would not meet its enrollment goal of 7 million people by the March 31 deadline. But sign-ups past that goal with the most recent estimates putting the number at 7.5 million, as people who started applications on or before the deadline were given extra time to finish them.
With a new face soon to be in charge at HHS and the enrollments largely on track, the White House is eager to see if more pragmatic efforts aimed at fixing problems with the nation's newest social program can emerge.
Even with the robust enrollment, implementation challenges remain for Burwell and the White House.
The administration has to improve customer service for millions of Americans trying to navigate the new system. And there's a concern that premiums may rise for 2015, attributed to the belief that many younger, healthier people appear to have sat out this year's open enrollment season.
On the political front, congressional Republicans remain implacably opposed to the Affordable Care Act, even as several GOP governors have accepted the law's expansion of safety-net coverage under Medicaid. GOP opposition means Republicans can be expected to continue to deny additional funds for implementation.
Senate Minority Leader Mitch McConnell., R-Ky., welcomed Sebelius' resignation and appeared to indicate an openness to dialogue with Burwell, even as he declared that "Obamacare has to go."
"I hope this is the start of a candid conversation about Obamacare's shortcomings and the need to protect Medicare," McConnell said.
Obama remained publicly supportive of Sebelius throughout the rough rollout, deflecting Republican calls for her resignation. But she was not by his side last week when he heralded the sign-up surge during an event in the White House Rose Garden.
The official said the 65-year-old Sebelius approached Obama last month about stepping down, telling him that the sign-up deadline was a good opportunity for a transition and suggesting he would be better served by someone who was less of a political target.
Sebelius dropped no hints about her resignation Thursday when she testified at a budget hearing. Instead, she received congratulations from Democratic senators on the sign-up surge.
A popular former governor of Kansas, Sebelius has been one of Obama's longest-serving Cabinet officials and his only HHS secretary. She was instrumental in shepherding the health care law through Congress in 2010 and implementing its initial components, including a popular provision that allows young people to stay on their parents' insurance plans until age 26.
But Sebelius' relationship with the White House was said to fray during the fall rollout of the insurance exchanges at the center of the sweeping overhaul. The president and his top advisers appeared caught off guard by the extent of the website problems, with warnings from those working on the technology never making it to the West Wing.
With technical problems crippling online sign-ups after the Oct. 1 launch, the White House sent management expert and longtime Obama adviser Jeffrey Zients to oversee a rescue operation that turned things around by the end of November. After taking the helm of the project, Zients said management issues were partly to blame but did not point the finger at any individuals.
Sebelius took personal responsibility for the chaotic launch of the website and asked the HHS inspector general to conduct an investigation. That report is not expected for months.
Al Jazeera and wire services