THCB

Should Sebelius Resign?

As Congress begins investigations into the Affordable Care Act rollout and the healthcare.gov flaws, Republicans are calling for resignations as far up as the Secretary of Health and Human Services. The logic goes: if managerial issues were behind failures to test the website component of the federal health care exchange, we need new management.

That concern is a valid one. In the private sector and often times in the public sector, when misakes happen—particularly in an area critical to the executive’s interests—heads roll.

Yet, Kathleen Sebelius will stay, and Republicans have no one to blame but themselves.

Why is this? In an ironic twist of fate the Republican Party’s obsession with filibustering, delaying, or holding executive branch nominations will finally have negative consequences for the GOP instead of the president.

Over the past several years, Republicans in Congress had refused to confirm a director of the Consumer Financial Protection Bureau because they did not like the law that authorized the agency. They refused to confirm nominees to the National Labor Relations Board because of opposition to unions. They put a hold on the chairman of the Federal Communications Commission for fear he may require more transparency in campaign activity. The examples go on.

Why, then, would President Obama remove Secretary Sebelius and nominate a replacement? The HHS Secretary oversees the implementation of the Affordable Care Act. And GOP opposition to CFPB or NLRB or FCC pales in comparison to the visceral and existential contempt the party feels toward Obamacare. Given such opposition, the president would be foolish to make such a change in HHS leadership.

The nomination of Richard Cordray to head the new CFPB is a perfect parallel. Republicans in Congress opposed this nomination—for years—not because Mr. Cordray was unqualified. In fact, some Senate Republicans praised his qualifications, but opposition to the structure of CFPB motivated a filibuster. Republicans didn’t oppose the nominee; they opposed the Dodd-Frank financial reform legislation.

This month, Republican opposition to the Affordable Care Act drove the party to shutdown the U.S. Government for over two weeks and brought Treasury to the brink of defaulting on the nation’s debt. Who in their right mind thinks the GOP won’t put a hold on or filibuster a—or ANY—prospective nominee to lead HHS?

A prospective HHS Secretary would face the same—or likely greater—opposition, regardless of his or her qualifications for the post. While Republicans spit venom at the consequences of the Dodd-Frank law, GOP opposition to Obamacare is more fundamental, leading some to call it a threat to freedom and American life.

As a result, one thing is clear: Kathleen Sebelius will be Mr. Obama’s last HHS Secretary to get Senate confirmation. That may be a problem, particularly if the managerial problems in federal exchange technology ultimately fall in her lap. However, any chance that the president will reasonably and effectively address managerial problems with a change in personnel is completely undermined by a broken confirmation system in the United States Senate.

As Republicans continue their investigations into the Obamacare rollout and strike harmony in the anthem of calls for resignations, they will find themselves victims of their own undoing. Each day that Secretary Sebelius reports for work, Republicans can rest assured of one fact: she remains at her job not because the 111th Congress confirmed her, but because the 113th Congress is too dysfunctional to confirm her successor.

John Hudak is a fellow in governance studies at the Brookings Institution and managing editor of the FixGov Blog, where this post originally appeared.

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16 replies »

  1. Agreed. But, it doesn’t look at this point that she will get the boot. I’m watching her testimony.

    If, however, they slip their self-professed end-of-November deadline and errors and access problems persist, I can’t see how she survives politically.

  2. Well said, Marty. Your argument is the core of what’s important here. Not the avoidance of political ramifications through yet more incompetence and ignorance.

  3. When Michael Brown failed during the Hurricane Katrina disaster, he resigned. Rightfully so. Although he was not responsible for the creation of Hurricane Katrina, he failed to orchestrate an acceptable response.

    Sebelius was charged with creating and implementing workable exchanges. The undertaking was botched, big time. It looks like no one was riding herd over the development, and no one was coordinating the process.

    This isn’t cold fusion nor rocket science – many businesses manage to create complicated but usable systems that aren’t such a colossal disaster. The technology exists; it’s not being invented here for the first time ever. Nor is it the first time anyone has ever managed an undertaking of this size and scope. That’s been done before too. It’s been done successfully under the auspices of competent managers.

    Sebelius and her lackeys need to go. They have shown a breathtaking level of incompetence and ignorance.

  4. John: thanks for the reply, especially the discussion about recess appointments.

    I appreciate your point that the President has few incentive-driven options. That, however, is the price of leadership. Leadership at its best has a sacrificial quality to it, because the leader himself or herself realizes and articulates the fact that circumstantial, or in this case political, tidiness cannot be the major determinant in choosing a path forward.

    Our national political system is broken, I think irretrievably so. Part of the disrepair is the utter unwillingness of the individuals in power to sacrifice their current political or future financial gain in the name of doing what is good for the country and correcting things that can and must be fixed. The Healthcare.gov fiasco is only the latest example, but it comes as the result of an attempt to overhaul 1/6th of the US economy and to supposedly fix the health insurance marketplace. As the President persists in permanent campaign mode and his ratings continue to plummet (they may soon dive to Congressional depths), we have a political class saving itself with the life preservers of technicalities, such as the things you point out. There is no legal or regulatory impediment to the President acting, well, presidential, except that it might not be picturesque.

  5. What is unfolding is an embarrassment. There is zero usability of the healthcare.gov site, just as with the HIT devices that doctors are being forced to use.

    And now, there is a bill to alter the F D and C Act to protect EHR devices from the FDA’s responsibility of vetting.

    Sebelius is toxic to the health of the US citizens. She should resign as should many others, especially Obama’s IT allstars.

  6. Vik:
    I appreciate your reading my piece and your interest being enough to comment. Let me pick a little bit at your comment and hopefully engage the discussion a bit. First, I do not “claim that the President is without options simply because the Congress…is the problem.” The piece argues that the incentives are not there for the President to dismiss Secretary Sebelius. Does he have options? Absolutely. He can dismiss her and have an Acting Secretary fill the spot as the order of succession in HHS as governed by Executive Order would dictate. He would even rearrange the order of succession within the Department if he preferred another individual. That said, there exist managerial problems, and often times “Acting” officials face additional issues when governing agencies or departments–legitimacy, infighting, competition, etc. Relying on “Acting” officials is not always ideal and comes with risks. That is not say keeping Sebelius is risk-free or even comes with fewer risks. But risks exist.
    To your point on the recess appointment, the decision is not entirely as simple as you lay out. The Supreme Court will hear a case this year on the ability of the president to make recess appointment. The current holding (the decision of the last court to rule on the case) comes from the US Court of Appeals for the District of Columbia. The decision dramatically restricts the ability of the president to issue recess appointments, even when the Senate as adjourned for a work period. In addition, while the Senate may adjourn in November, they may continue holding pro-forma sessions which the Senate has agreed to do as a type of “truce” to prevent recess appointments. After the Court issues a ruling in May or June, the president will have greater guidance about his Constitutional power to recess appoint.

    Finally, and just to be clear, my argument in the piece does not engage whether the president’s keeping Sebelius on is right or wrong. It simply argues that he is unlikely to dismiss her because the incentives are not there for him to do so. It makes the broader point that government dysfunction and unnecessary gridlock have serious consequences for governance and bureaucratic management. Whether those consequences exist despite there being achievable alternatives does not detract from the point that those consequences exist. The point remains: if Congress were more willing to entertain presidential nominations, give them a fair hearing, and then let a majority of Senators vote on confirmation, I think Secretary Sebelius would have “Fmr.” in front of her name very quickly.

  7. Interesting analysis by Mr. Hudak. I agree with it, to an extent. I think it’s unlikely Sec. Sebelius will step down, in part because any new confirmation battle would be politically costly and probably futile for the White House. But her resignation would also be perceived as an admission that the Exchange challenges really were a result of poor management and not because the sites are so complex, there has been so much interest, etc. The Administration has a strong interest in keeping those positions alive to balance the discourse here.

    Put this in the bona fide rumor camp, but there is some buzz around the campfire that, if the political heat becomes too strong for Sec. Sebelius to hang on, the President could reach out to a moderate Republican as a replacement – think former Administrator McClellan or Secretary Mike Leavitt. There are all kinds of reasons why that would never happen too, but I bet you that thought will cross the minds of some in the White House if they begin to believe the Secretary needs to go. Her appearance this Wednesday before the Energy & Commerce Committee will be an important next chapter in this story.

  8. Incomplete sentence should read as:

    To intimate that a cabinet chief responsible for the failed implementation of a law that actually may help some people should not resign both defies logic and belies any statement that buck stops at the Resolute desk.

  9. There was obviously no “only” time, unless you consider the last 50 years the “only” time. Every administration since Johnson’s has executed perfectly their opportunity to screw the system up and nicely avoided taking the steps needed to make fixes because it’s hard to stiff the people who control the campaign contribution purse strings. Your administration’s contribution was Medicare Part D.

    The Secretary needs to go. The President dismissed General Stan McChrystal for far less…impertinent comments in a magazine interview. To intimate that a cabinet chief responsible for the failed implementation of a law that actually may help some people both defies logic and belies any statement that buck stops at the Resolute desk.

  10. Vik –

    If you look back at the posts here, you will see that I have been trying to sign up for care through Obamacare (and am sympathetic to much of the law, given my and my family’s health status).

    That said, this post and my comments focus on the execution of the secretary and the administration – not the need for the law itself.

    (I’ll leave it to others to hash out whether 2001-09 was the only time to address the dysfunctions of the health system.)

  11. Funny for a Bush 43 appointee to make these observations.

    Here’s an observation for you: if you and your colleagues, including and up to W himself, had done anything of value in correcting healthcare marketplace dysfunctions, then the ACA likely never happens.

  12. Bubba: not only should somebody resign, it is ludicrous for the writer to claim that the President is without options simply because the Congress, run by petulant, ignorant children, is the problem. The problem is the lack of any understanding of the concept of “leadership” in Washington broadly and in the White House, in particular.

    Sebelius needs to go and so, too, do the political appointees in the tiers below her who are directly responsible for the Healthcare.gov’s Grade F launch. Given that the Senate session is scheduled to end around Nov. 9, my understanding is that the President has it within his power to make a recess appointment of a new HHS leader. He could easily turn the tables on Republicans by appointing someone with the commerce and technology chops to get the fixes made because as of right now, no matter whether you find the law palatable or not, that is the number 1 priority. It doesn’t even matter if this person sticks around for the rest of the President’s term or not. Most of health policy and operations is driven by the bureaucracy, and what exactly has Sebelius brought to the table that any rational person would miss?

    As for the HHS calling in Verizon to help now, what planet are these people on? We are home to most sophisticated e-commerce companies in the world. Uh, lemme see if I can think of a few: Amazon, PayPal, E-bay, Walmart, Target, FedEx, UPS, etc. These companies not only handle hundreds of millions of dollars in international transactions daily, they manage their supply chains and their retail operations seamlessly and, from my perspective as an e-customer of all those firmss, nearly flawlessly. Did anyone think that it might help to have actual e-commerce experts and their consultants on board in the design and launch process instead of government contracting slugs like CGI?

    This entire Healthcare.gov launch animates every citizen’s worst nightmare about the fecklessness of government. The only way to redeem it is for the President to do what he normally doesn’t do: actually lead.

  13. As a former HHS political appointee (2001-05), I largely agree with these points.

    I have to think at this point:

    1. Sebelius has offered to resign, knowing full well it wouldn’t be accepted. It is the decent thing to do given the debacle of a rollout of the President’s signature legislative achievement.

    2. The White House said no, given the points raised above and the president needs a secretary in place through the (trainwreck-y) launch of this thing.

    3. No politician wants to be defined by the grievances of others, and firing or accepting the resignation of Sebelius just four weeks after the launch is just not done (whether it should be or not).

    That said, does Sebelius finish out the term? No. I’ll put the resignation announcement between Election Day and Christmas 2014.

  14. SOMEBODY should resign – the lack of accountability is a huge part of the problem. If Sec Sebelius been a US. general in Afghanistan she would have been on the plane home two weeks ago ..

  15. Unfortunately, if she resigned, we would not have an HHS Secretary during President Obama’s administration.”

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