By Louise Radnofsky
The U.S. Senate on Thursday voted 78-17 to place Sylvia Mathews
Burwell in charge of the Department of Health and Human Services,
which steers implementation of the Affordable Care Act.
The confirmation of Ms. Burwell, 48, as health and human
services secretary, marks a shift for an agency that has been
headed by former governors for the past 14 years. Kathleen
Sebelius, the current secretary and former Kansas governor, focused
for much of her five years in the job on selling the 2010 health
law to the American public.
Ms. Burwell, by contrast, brings management experience to the
job that former colleagues say will help her lead the agency's big
projects. Chief among them is ensuring that HealthCare.gov operates
smoothly during this fall's insurance enrollment period after a
disastrous rollout last year.
Ms. Burwell, who will be leaving the job of director of the
Office of Management and Budget, previously had high-level
positions in the Clinton White House, Gates Foundation and Walmart
Foundation, but has never held elected office.
"She goes very, very deep on the details, but she has a very
broad policy lens," said Leslie Dach, the former executive vice
president of corporate affairs for Wal-Mart, who wooed her in 2011
to become president of the company's foundation. She worked there
for just over a year before coming back to Washington.
Those traits will be tested at the Department of Health and
Human Services, a 78,000-employee agency that, in addition to
wrestling with enacting the Affordable Care Act, also oversees
Medicare, Medicaid, disease control, food and drug regulation, and
funding for medical research in the U.S.
Patty Stonesifer, the former chief executive officer of the
Gates Foundation, and Helene Gayle--the former head of the
foundation's AIDS, tuberculosis and reproductive health
programs--said that Ms. Burwell's work there included helping the
foundation figure out how to make strategic funding investments and
wrapping up grants and programs when their life span was up.
Ms. Burwell has some experience dealing directly with health
systems, having served on the board of University of Washington
Medical Center from 2002 to 2005. During that time, the hospital
went through a major overhaul of its information technology. It was
also trying to review missteps and set up a compliance program in
the wake of a federal investigation into Medicare billing problems
in the 1990s.
People who have worked with Ms. Burwell have described her deft
political skills, which have typically been used outside of the
limelight. Those traits were on display in her path to
confirmation, which appeared to be eased by her ability to forge
relationships with key senators. Several Republicans had been vocal
in criticism of the Obama administration, but praised her.
Among them were Utah Sen. Orrin Hatch, Arizona Sen. John McCain
and Oklahoma Sen. Tom Coburn, as well as Georgia Sen. Johnny
Isakson. Mr. Isakson said at the outset of her confirmation process
that he wouldn't let Ms. Burwell leave the Office of Management and
Budget until he was satisfied with her answers about the agency's
role in approving an expansion project for the Port of
Savannah.
She also had the vocal backing of a roster of Democratic
politicians, including Sens. Jay Rockefeller and Joe Manchin and
Rep. Nick Rahall, all from her home state of West Virginia.
Write to Louise Radnofsky at louise.radnofsky@wsj.com
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