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Life Health > Health Insurance > Health Insurance

Sylvia Mathews Burwell: The next HHS secretary?

By Joe Sobczyk and Annie Linskey

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(Bloomberg) — Sylvia Mathews Burwell, President Barack Obama’s choice to be his next secretary of Health and Human Services, brings experience in budgeting and management and one other important qualification: proven ability to get confirmed by a divided U.S. Senate.

Obama plans today to name Burwell, currently the director of the Office of Management and Budget (OMB), to succeed Kathleen Sebelius, who has been under attack by Republicans for the fumbled start of the president’s signature health-care law.

The switch now means that Burwell’s confirmation hearings will be held amid campaigning for the midterm congressional elections in which the law, known as Obamacare, is a prime target for Republicans.

When Obama nominated Burwell last year as his budget director, she went before the Senate as Obama and Republicans were squaring off in another battle: raising the federal debt limit and dealing with the automatic budget cuts known as sequestration.

She was confirmed on a 96-0 vote.

Even so, any Senate hearing for Sebelius’s successor will be “bruising” said Jim Manley, a former top aide to Senate Majority Leader Harry Reid, a Nevada Democrat.

“Republicans think that they’ve seized on a winning narrative when it comes to Obamacare,” Manley said in a telephone interview. “They’ll be bound and determined to make as much hay out of a confirmation process as they can as they try to put the program in the worst possible light.”

While Burwell’s previous experience in the confirmation process will help, “I’m not so sure she can expect to get the numbers for confirmation that she got for OMB director,” he said. “I assume it will be much more partisan this time.”

Senator Mitch McConnell of Kentucky, the Senate Minority Leader, said in an e-mail that Burwell’s nomination should be “the start of a candid conversation about Obamacare’s short- comings and the need to protect Medicare for today’s seniors, their children and their grandchildren.”

Burwell, 48, is familiar with the territory. She was deputy director of the OMB near the end of the Clinton administration, another time when government control was divided and the partisanship was intense.

Burwell has acknowledged that the difficulties she faces in today’s partisan climate are greater than in the 1990s.

“The main difference that I would articulate is the alignment between the Republicans during that period,” the West Virginia native said in an interview late last year. That unity “helps one get to solutions,” she said.

A graduate of Harvard University and Oxford University as well as a former Rhodes Scholar, Burwell also was President Bill Clinton’s deputy chief of staff. Before joining the Clinton White House she was chief of staff to then-Treasury Secretary Robert Rubin.

After leaving Washington, Burwell worked in philanthropy. She ran the global development program at the Bill and Melinda Gates Foundation. In January, 2012 she was named president of the Wal-Mart Foundation, which gave $959 million in cash and in- kind contributions worldwide in 2011, according to its website. She held the job until Obama chose her for OMB in March, 2013.

Her White House connections are deep. National Security Adviser Susan Rice helped introduce Burwell to her husband, lawyer Stephen Burwell, with whom she has two children. The two women first met as Rhodes Scholars at Oxford University. Housing and Urban Development Secretary Shaun Donovan was a dormitory mate at Harvard.

At OMB, Burwell oversaw preparation of the government’s $3.8 trillion annual budget, representing about one-fourth of the U.S. economy.

One of the reasons Obama picked her to take over HHS was her track record in navigating through the partial government shutdown last October and helping win a two-year budget agreement, according to an administration official, who asked for anonymity because the decision hasn’t been announced.

The U.S. Department of Health and Human Services (HHS) budget for fiscal year 2015 is just over $1 trillion, more than 80 percent of that for Medicare and Medicaid, the health insurance programs for those over 65 and the poor.

Along with the Centers for Medicare & Medicaid Services (CMS), HHS oversees the Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health.

It also plays a central role in administering the Patient Protection and Affordable Care Act (PPACA0. Sebelius told a Senate hearing this week that 7.5 million people had enrolled in private health plans under the law.

–With assistance from Lisa Lerer and Julianna Goldman in Washington.

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