New HHS sec­re­tary nom­i­nee has miles to go with ACA com­ple­tion

Modern Healthcare - - LATE NEWS - —Paul Demko

HHS Sec­re­tary Kathleen Se­be­lius stepped down Fri­day af­ter five tu­mul­tuous years in Wash­ing­ton, stand­ing at Pres­i­dent Barack Obama’s right hand as he an­nounced her res­ig­na­tion and his nom­i­nee to suc­ceed her, Of­fice of Man­age­ment and Budget Di­rec­tor Sylvia Mathews Bur­well.

Bur­well’s re­sume in­cludes serv­ing as pres­i­dent of the Wal­mart Foun­da­tion and as a deputy chief of staff to Pres­i­dent Bill Clin­ton. That ex­pe­ri­ence makes her a strong pick for the post, said Dr. Mark McClellan, a se­nior fel­low at the Brook­ings In­sti­tu­tion and CMS ad­min­is­tra­tor and Food and Drug Ad­min­is­tra­tion com­mis­sioner un­der Pres­i­dent Ge­orge W. Bush.

“There is still a tremen­dous amount of work to do for the Af­ford­able Care Act im­ple­men­ta­tion to be com­pleted,” he said.

Bur­well will have to carry out that work un­der po­lit­i­cal op­po­si­tion to the ACA that re­mains as in­tense as it was four years ago when it was en­acted. HHS still has to re­solve prob­lems with the state and federal ex­changes’ back­end tech­nol­ogy to make sure the mar­ket­places are func­tion­ing ef­fec­tively when 2015 open en­roll­ment be­gins Nov. 15. In ad­di­tion, Bur­well will need to work closely with in­sur­ers to keep them on board with the mul­ti­year roll­out of the ex­changes.

And HHS will need to mount an on­go­ing ed­u­ca­tion cam­paign aimed at the gen­eral pub­lic about the law’s rules and ben­e­fits. Polls have re­peat­edly sug­gested that too many people re­main ig­no­rant about key pro­vi­sions of the law.

Joseph An­tos, a health­care pol­icy ex­pert at the con­ser­va­tive Amer­i­can En­ter­prise In­sti­tute, ques­tioned Bur­well’s lack of busi­ness ex­pe­ri­ence. Many businesses are frus­trated by the law’s bumpy roll­out and re­peated rule changes, he said.

But even though her nom­i­na­tion is com­pli­cated by the toxic pol­i­tics of Oba­macare, Bur­well isn’t ex­pected to face a se­ri­ous con­fir­ma­tion threat. She was ap­proved last year in her cur­rent post by a 96-0 vote.

“There will be a huge amount of sturm und drang,” said Theda Skocpol, a govern­ment and so­ci­ol­ogy pro­fes­sor at Har­vard Univer­sity, “and there will be a lot of yelling and scream­ing, but she’ll be con­firmed.”

Pres­i­dent Barack Obama an­nounces the res­ig­na­tion of HHS Sec­re­tary Kathleen Se­be­lius, at left, and the nom­i­na­tion of OMB Di­rec­tor Sylvia Mathews Bur­well, right, to re­place Se­be­lius.

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