New Face, Same Old Problems for
Obamacare
Friday, 11 Apr 2014 04:51 PM
Abruptly on the spot as the new face of
"Obamacare," Sylvia
Mathews Burwell faces steep challenges, both logistical and
political.
Burwell, until now White House budget
director, was named by President Barack Obama on
Friday to replace Health and Human Services
Secretary Kathleen Sebelius, who oversaw the
messy rollout of the health care overhaul. Now the new secretary must keep the
complex program running smoothly and somehow help restore a cooperative
dialogue with Republicans who are hoping to use the law's problems to regain
control of the Senate in November.
At an upbeat Rose Garden event, Obama
showered praise on Sebelius, a hero for his party's liberal base, whose
impending retirement had been a tightly guarded secret.
The president ignored calls for Sebelius
to resign last fall, after the website for consumers to enroll in new coverage
experienced weeks of crippling technical problems. Last month, as it started to
look like sign-ups would beat expectations, Sebelius approached the White House
about stepping aside, officials said.
"Under Kathleen's leadership, her
team at HHS turned the corner, got it fixed, got the job done," Obama
said. "And the final score speaks for itself." About 7.5 million
people have signed up for subsidized private health insurance through the new
law, exceeding an original target of 7 million widely thought to be
unattainable because of the website problems.
Obama quickly pivoted to Burwell, 48, a
low-profile Washington
veteran now serving as his budget chief. He stressed her role last year in
helping to end a government shutdown and reach a two-year budget deal with a
politically divided Congress.
"Sylvia is a proven manager, and she
knows how to deliver results," Obama said.
Senate Finance Chairman Ron Wyden, D-Ore.,
who will hold confirmation hearings for Burwell, said there's an opportunity
chance for her to move the health care debate beyond stalemate.
While a political truce is unlikely over
Obama's health overhaul, Wyden ticked off a list of other issues where
Republicans and Democrats might be able to find compromise. Among them:
revamping the way Medicare pays doctors, providing coordinated care for
patients with chronic illnesses and using data to encourage delivery of quality
health care at lower cost.
Although health care spending has grown at
historically low rates during Obama's tenure, a reviving economy could stoke
cost problems anew for businesses, government programs and consumers.
Health and Human Services is a $1 trillion
agency that plays a key role in American society and the economy. More than 100
million people receive coverage through Medicare, Medicaid, and now Obama's
health law. The secretary also oversees the Food and Drug Administration, which
regulates a broad range of consumer products, and the Centers for Disease
Control and Prevention, the front line for public health.
But Burwell could have her hands full
addressing issues with the health care law, predicted Brookings
Institution health economist Mark McClellan.
"Don't underestimate the remaining
implementation challenges for the Affordable Care Act," said McClellan,
who oversaw the rollout of the Medicare drug benefit for President George W.
Bush. "It's true that the first open enrollment season is over, but that
was just the front end of the implementation process."
Among those challenges:
Keeping premiums affordable for 2015. Many
younger people whose premiums would help offset the cost of care for older,
sicker adults appear to have sat out the first sign-up season.
Overhauling the sign-up process to make it
more consumer-friendly. Supporters of the law say more in-person assistance is
needed for the next enrollment season, which begins Nov. 15.
Working with states that are still opposed
to, or undecided about, the law's Medicaid expansion. Nearly half the states
have not signed on to the law's mechanism for expanding coverage among
low-income adults.
Helping to guide administration policy on
how to enforce the law's penalties for individuals who remain uninsured and the
medium- to large-sized businesses that do not provide affordable coverage to
their employees.
She'll be facing a Congress that's
unlikely to provide any additional funding to help the administration smooth
over implementation problems.
Burwell has three tests immediately ahead,
said former HHS Secretary Mike Leavitt, who also served under Bush. "Get
confirmed. learn the department. prioritize the challenges."
Burwell has a head start on the first two;
how she'll do on the third remains to be seen.
She was confirmed by the Senate 96-0 for
her current post last year, and Obama said with a smile, "I'm assuming not
much has changed since that time."
As budget chief, Burwell is already
familiar with the details of health care programs and how they work. Budget
experts in both political camps agree that health care is the main driver of
long-term growth in federal spending.
As she announced her resignation Friday,
Sebelius called her work on the health care overhaul the "cause of my
life."
"We are at the front lines of a
long-overdue national change," she said.
Sebelius has served as Obama's health and
human services chief for five years, and helped steer the sweeping health law
through Congress in 2010. But her tenure was marred by complaints from Congress
that her department was not upfront about implementation problems. That seemed
to be confirmed last October, with the dysfunctional launch of HealthCare.gov.
The problems frayed her close relationship
with the White House. West Wing officials said they felt blindsided by the extent
of the technical problems and installed a longtime Obama adviser to oversee
fixes.
White House officials said Sebelius
approached the president about stepping down a month ago, suggesting that the
close of the six-month enrollment window marked a natural point for a
transition. Officials said she also told the president he would be better
served by a secretary who was less of a political target.
House Minority Leader Nancy Pelosi, a
staunch supporter of the health care law, praised Sebelius as a "forceful,
effective and essential" secretary.
Sylvia Mathews Burwell
Sylvia
Mathews Burwell is the secretary-nominee for the U.S.
Department of Health and Human Services (HHS), a director at the U.S. Office of Management and Budget, was the deputy
director for the U.S. Office of Management and Budget,
an associate for McKinsey & Company, and the
president, global development for the Bill & Melinda Gates
Foundation.
Note: Alice
M. Rivlin was a director at the U.S. Office of Management
and Budget, and is a trustee at the Committee
for Economic Development.
George P.
Shultz was a director at the U.S. Office of Management
and Budget, and a trustee at the Committee
for Economic Development.
John P.
White was the deputy director for the U.S. Office of Management
and Budget, and a trustee at the Committee
for Economic Development.
Leonard
T. Mendonca was a partner at McKinsey & Company,
and is a co-chairman for the Committee for Economic
Development.
Dominic
Barton is a global managing director for McKinsey
& Company, and a trustee at the Committee
for Economic Development.
Donald
C. Waite III is a director emeritus at McKinsey & Company,
and was a trustee at the Committee for Economic
Development.
Roger
W. Ferguson Jr. was a partner at McKinsey & Company,
and is a co-chairman for the Committee for Economic
Development.
Bill
& Melinda Gates Foundation was a funder for the Committee
for Economic Development.
Foundation
to Promote Open Society was a funder for the Committee
for Economic Development.
George Soros
was the chairman for the Foundation to
Promote Open Society.
Donna S.
Morea was a trustee at the Committee for Economic
Development, and the EVP for the CGI Group
Inc.
CGI
Group Inc. was the Obamacare
contractor that developed Healthcare.gov web site.
Obamacare
is Barack Obama’s signature policy
initiative.
Barack Obama’s
signature policy initiative is Obamacare, and was
an intern at Sidley Austin LLP.
Dora Hughes
is a senior policy adviser at Sidley Austin LLP,
and was Kathleen Sebelius’s counselor at the U.S. Department of Health and Human Services (HHS).
Howard K.
Koh is the assistant secretary at the U.S. Department of Health
and Human Services (HHS) for the Barack Obama
administration, and his brother is Harold H.
Koh.
Harold H. Koh
is Howard K. Koh’s brother, was the State
Department legal adviser for the Barack Obama
administration, and a director at Human Rights
First.
Foundation
to Promote Open Society was a funder Human Rights First.
George Soros
was the chairman for the Foundation to
Promote Open Society.
James D.
Zirin was a director at Human Rights First,
and is a senior counsel at Sidley Austin LLP.
Mark A.
Angelson was a director at Human Rights First,
and a partner at Sidley Austin LLP.
Michelle
Obama was a lawyer at Sidley Austin LLP.
R. Eden
Martin is counsel at Sidley Austin LLP,
and the president of the Commercial Club of Chicago.
Newton N.
Minow is a senior counsel at Sidley Austin LLP,
and a member of the Commercial Club of Chicago.
Cyrus
F. Freidheim Jr. is a member of the Commercial Club of Chicago,
and an honorary trustee at the Brookings Institution
(think tank).
Bill
& Melinda Gates Foundation was a funder for the Brookings Institution (think tank).
Foundation
to Promote Open Society was a funder for the Brookings Institution (think tank).
George Soros
was the chairman for the Foundation to
Promote Open Society.
Mark
B. McClellan was a senior fellow at the Brookings
Institution (think tank), and an administrator of Medicare and Medicaid for the U.S.
Department of Health and Human Services (HHS).
Alice M.
Rivlin is a senior fellow at the Brookings
Institution (think tank), and was a director at the U.S. Office of Management and Budget.
Cass R.
Sunstein is a senior fellow at the Brookings
Institution (think tank), married to Samantha
Power, and was the chief regulatory officer for the U.S. Office of Management and Budget.
Nancy
Killefer is a senior director at McKinsey
& Company, and was the nominee for chief performance officer for
the U.S. Office of Management and Budget.
Dominic
Barton is a trustee at the Brookings
Institution (think tank), and a global managing director for McKinsey & Company.
D.
Ronald Daniel was an honorary trustee at the Brookings Institution (think tank), and is a director at McKinsey & Company.
Martin
N. Baily was a senior fellow at the Brookings
Institution (think tank), and a principal at McKinsey & Company.
Lael
Brainard was a VP & director at the Brookings
Institution (think tank), a consultant for McKinsey & Company, and is the under secretary for
international affairs at the U.S. Department of the
Treasury for the Barack Obama
administration.
Sheryl
K. Sandberg is a trustee at the Brookings
Institution (think tank), and a management consultant for McKinsey & Company.
Susan E.
Rice was a senior fellow at the Brookings
Institution (think tank), a management consultant for McKinsey & Company, a former U.S. ambassador to UN for the Barack Obama administration, and is the White House national
security adviser for the Barack Obama
administration.
Sylvia
Mathews Burwell was an associate for McKinsey & Company,
the president, global development for the Bill & Melinda Gates
Foundation, the deputy director for the U.S. Office
of Management and Budget, is a director at the U.S. Office
of Management and Budget, and the secretary-nominee for the U.S. Department of Health and Human Services (HHS).
Bill
& Melinda Gates Foundation was a funder for the Committee
for Economic Development.
Foundation
to Promote Open Society was a funder for the Committee
for Economic Development.
George Soros
was the chairman for the Foundation to
Promote Open Society.
Donna S.
Morea was a trustee at the Committee for Economic
Development, and the EVP for the CGI Group
Inc.
CGI
Group Inc. was the Obamacare
contractor that developed Healthcare.gov web site.
Obamacare
is Barack Obama’s signature policy
initiative.
No comments:
Post a Comment