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Sebelius out as HHS head; Obama nominates replacement

Saturday April 12, 2014
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In the wake of Kathleen Sebelius’ decision Thursday, April 10 to resign as secretary of the Department of Health and Human Services, President Obama has nominated Sylvia Mathews Burwell to take Sebelius’ place as the nation’s chief health administrator.

Burwell, the administration’s budget director, must be confirmed by the Senate. If confirmed, she will face the task of continuing to implement the Affordable Care Act. As HHS secretary, she also will oversee the heads of numerous federal agencies, including the CDC, Centers for Medicare & Medicaid Services, Food and Drug Administration, Health Resources and Services Administration and National Institutes of Health.

Sebelius, who has been in her position since April 2009 and before that was governor of Kansas, bore the brunt of the criticism for the technical problems that made online enrollment through the new federal health insurance exchange all but impossible in October and November.

During a Senate committee hearing Thursday, before announcing her resignation, Sebelius said 7.5 million people have enrolled in a plan via the exchanges. That number exceeds initial projections, although the administration has not said how many people have actually begun making premium payments and how many previously were uninsured.

Recent reports have put the net gain in insured individuals at between 9 million and 10 million for 2014, compared with hypothetical levels in the absence of the ACA. That total includes some of those who have enrolled via the exchanges, people who are eligible for expanded Medicaid in some states and young adults who are eligible to stay on their parents’ insurance plan until age 26.

If confirmed, Burwell — a West Virginia native, Rhodes Scholar and former president of the Walmart Foundation who also served in the Clinton administration — will be charged with continuing to implement the many facets of the ACA. The next open enrollment period begins in November, and even many of the law’s supporters say changes are needed.

For example, six Senate Democrats recently proposed a series of changes, including a cheaper plan option in the exchanges and restoration of funding to nonprofit healthcare co-ops in an effort to boost competition in the marketplaces; an expansion of tax credits to small businesses; and granting employers with 50 to100 employees an exemption from the requirement to provide coverage.

Republicans in Congress, meanwhile, say they hope to find a way to repeal the entire law.

Burwell does not have an extensive background in healthcare policy, but in her role as federal budget director she has strived to improve the efficiency of various agencies and minimize wasteful spending. She will seek to apply those skills to the monumental effort to control healthcare costs.

In a statement, Rich Umbdenstock, president and CEO of the American Hospital Association, lauded Sebelius’ “commitment to improving healthcare and expanding access to care for all. Her work to extend coverage to millions of Americans will be part of her legacy. While shepherding through some of the biggest challenges in healthcare, Sebelius always had an open door and listened to hospital leaders on issues affecting the field.”

Umbdenstock stated the AHA looks forward to working with Burwell “to advance better health for the patients and communities we serve.”


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