ACA Signups hit 7.5 million. Sebelius Steps Down. Mathews-Burwell to Lead HHS.

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In a development that Washington insiders had been quietly predicting for months,  Kathleen Sebelius announced Thursday that she is resigning as HHS Secretary. Critics were quick to point to the disastrous launch of Healthcare.gov and the glitch-filled rollout of the administration’s signature health law.

President Obama is expected to nominate  OMB  Director Sylvia Mathews Burwell to replace Sebelius Friday morning.  The Washington Post notes that Mathews-Burwell is well regarded for her “strong management skills”  and cites her experience in global health after ten years with the Bill and Melinda Gates Foundation.

Politico reports that while publicly praising Sebelius for having overseen a late surge in enrollments that brought signups up to the 7.5 million mark  by the time she announced her departure today,  many Democrats are said to be privately “furious” about how badly the Obamacare rollout went and are worried that debacle could cost them control of the Senate in November.

If you’re curious about Burwell’s resume – after all – we’re talking about the woman who will (probably) be the official face of Obamacare until at least 2017 – WonkBlog did some digging back at the time of the hearings for the OMB job.

Confirmation Crazyness:  It’s safe to expect the Mathews-Burwell confirmation will be one of the more entertaining in recent years, with GOP critics taking every opportunity to score points by reminding the American public of how badly the rollout went and Democrats arguing that, well – they went pretty well, all things considered.

How well will that go? A lot will depend on what happens between now and then. With ACA signups seemingly back on track, Democrats will make the case that it is time to set politics aside and move on. Any early problems and confusion as new enrollees attempt to use their new policies are  likely to become the focus of attacks.  You can also expect a mind-numbing argument about the numbers (signups vs. QHPs vs. those who have paid) and the relatively affordability of new plans. You can also expect to hear the phrases “you can keep your plan” and “you can keep your doctor” uttered repeatedly and with feeling.

Tainted Legacy : The sighing sound you just heard is Democrats  exhaling at the thought that the Healthcare.gov crisis may finally be officially over.  The Mathews-Burwell appointment is likely to provide some closure but is unlikely to do much for the career of Kathleen Sebelius, who – rightly or wrongly – is going to be forever associated in the minds of the American public with the Healthcare.gov fiasco.

If you’re wondering how fair that really is, you’re not alone.  Sebelius can be expected to play the part of the loyal administration footsoldier and take one for the team. Expect her to show up again in the private sector, where new opportunities await.

The Conversation We’re Not Having Yet, But Will: Was there a better choice to the lead the most important Washington initiative since the wars in Afgahanistan and Iraq? With Mathews-Burwell the Obama administration went with an experienced Washington policy insider, a logical enough move, but there are arguments to be made for different approaches.  Given the chaos of the rollout, a strong case could also have been made for a popular healthcare  insider with the soft skills to smooth over the political damage left by administration’s near debacle.  An outsider from the private sector, particularly a a seasoned tech executive with proven experience running the kind of online marketplace Healthcare.gov was originally intended to be.  On the other hand, it is unclear who – if anybody – would have been willing to take the job. With the clock ticking, the goal is to get this done as quickly and possible.


5 replies »

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  3. Was there a better choice to the lead the most important Washington initiative since the wars in Afgahanistan and Iraq?

    There could be a list as long as your arm, but an Obama nomination has become the kiss of death. It became clear when Donald Berwick was not allowed to head CMS that “better choices” means an impressive CV is less important than threading political needles.

  4. “many Democrats are said to be privately “furious”…


    Well-rehearsed moths-to-the-lenses Indignation has become the bitcoin currency of the Beltway anymore. We’re “bipartisian” in that sense.