In nominating Sylvia Mathews Burwell as his next HHS secretary, President Barack Obama has chosen someone recognized by insiders on both sides of the political aisle as an effective manager who is unlikely to become snagged in the politics of Obamacare.
When news broke late Thursday that she was Obama's choice to succeed Kathleen Sebelius, many in healthcare—even those with deep ties to HHS—had little idea who she was, even though she is a veteran of the Clinton administration and has served for the past year as Obama's director of the Office of Management and Budget.
Her lack of direct experience in healthcare has caused some to question her qualifications for the job, but many observers and former colleagues say her management expertise and low-profile style make her a perfect fit.
“She's someone who naturally doesn't seek the limelight—her focus was always on policy, not her public profile,” said Michael Feldman, a former senior adviser to former Vice President Al Gore who interacted with Burwell frequently, especially during her stint as President Bill Clinton's deputy chief of staff.
Feldman described Burwell as a consummate professional who's often at the center of handling things when a crisis hits. She was a go-to person for advice because she knew how to get things done, said Feldman, who now runs the PR firm The Glover Park Group.
Douglas Smith, a former assistant secretary at the Department of Homeland Security and another alumnus of the Clinton administration, similarly recalled Burwell as a “highly competent professional who never looked for headlines, but was someone always looking for solutions.”
In her year as director of the OMB, she has kept the agency out of the news despite the influence the department has in how federal funds are spent, said Smith, who now runs the Washington office of the PR firm MWW.
Before joining the Obama administration, Burwell was the president of the Walmart Foundation, the charitable organization. In 2001, she joined the Bill & Melinda Gates Foundation, where she had various roles before exiting in 2011 to move back to the East Coast to be closer to her parents.
During her time at the foundation, she crossed path a few times with Dr. Scott Gottlieb, a former deputy commissioner at the Food and Drug Administration and a resident fellow at the American Enterprise Institute, a conservative think tank.
“The president chose a highly competent inside-the-government operator who knows how to work the regulatory process and move the freight on the nitty gritty of getting a law implemented rather than a person with a big profile who can go around the country marketing the law and can exercise a lot of stroke on Capitol Hill,” he said.
Her experience at OMB has provided Burwell with a keen understanding of how the executive branch really works that will serve her well as HHS secretary, said Kip Piper, a Washington-area consultant and former senior official at the CMS and OMB. It also means she has a strong working relationship with and the trust of the president, which is critical to the success of any cabinet member, Piper said.
Obama also probably found it appealing that she has now been vetted so thoroughly that her closet must be skeleton-free, he said.
Others, likewise, expect a smooth confirmation. A year ago, the Senate voted 96-0 to confirm her nomination for the OMB post.
“While Ms. Burwell will certainly be grilled for lacking a healthcare background, I'm not convinced that that's essential for the position,” said Yevgeniy Feyman, a fellow at the Manhattan Institute, a conservative think tank. “The management skills she's acquired and the ability to work with, not against, Republicans are most important here.”Follow Virgil Dickson on Twitter: @MHvdickson