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Sylvia Mathews Burwell, secretary of HHS nominee

Reform Update: HHS nominee Burwell poised for Senate scrutiny

By Paul Demko
Posted: May 2, 2014 - 2:45 pm ET

Sylvia Mathews Burwell is widely expected to be confirmed as the next secretary of HHS. Democrats have the votes to approve her appointment even without Republican support. But that doesn't mean there won't be plenty of tough questions and political posturing when she appears Thursday before the Senate Health, Education, Labor & Pensions Committee.

Burwell currently serves as the director of the Office of Management and Budget. The Senate confirmed her last year for that post 96-0.

Few significant concerns have been raised this time around about Burwell's acumen or fitness for the top spot at HHS overseeing the $1 trillion agency. The 49-year-old West Virginia native's resume includes stints as the president of the Walmart Foundation, chief operating officer of the Bill and Melinda Gates Foundation and deputy chief of staff to President Bill Clinton.

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But the hearing will present an opportunity for Republicans to reiterate the perceived failings of President Barack Obama's signature healthcare law. In particular, GOP critics are expected to home in on a lack of transparency in regard to exchange enrollments and the administration's use of executive authority to make significant changes to the law. Republicans perceive the issue as a political boon for November's midterm congressional elections. The confirmation hearings present them a golden opportunity to slam Obamacare, and see how some planned campaign message points resonate with potential November voters in the process.

“It is an unfortunate fact that the confirmation process is used typically by both parties to highlight differences as opposed to just (considering) the fitness of the candidate,” said Michael Leavitt, who served as HHS secretary during President George W. Bush's administration and now is chairman of the consulting firm Leavitt Partners. “That was true with the Bush administration with the Democrats and I'm sure it will be true for the Obama administration with Republicans.”

Wednesday, five members of Louisiana's congressional delegation sent a letter imploring the state's senators to block Burwell's nomination (PDF). It's likely no coincidence that one of those senators, Mary Landrieu, is a Democrat in a tough re-election contest where the healthcare law is expected to play a crucial role.

Burwell's second stop will be before the Senate Finance Committee. That hearing has yet to be scheduled, but is expected before the end of the month.

“I think in the final analysis she'll be confirmed,” Leavitt said, “unless something comes up that nobody knows about.”

22 states top projected enrollment, study says

Nearly half of the states exceeded enrollment targets during the recently concluded open-enrollment period for Obamacare, according to an analysis by Avalere Health. The healthcare consulting firm based its findings on the Congressional Budget Office's projection that 6 million individuals would sign up for coverage and assumed that 15% of enrollees wouldn't follow through with premium payments. Three states—California, Florida and Idaho—had more than 160% of projected enrollments. Conversely, nine states, including New York, Massachusetts and Minnesota, failed to reach 70% of projected enrollments.

AHA backs Pryor, Begich for Senate

The American Hospital Association's PAC is running television ads supporting Democratic Sens. Mark Begich of Alaska and Mark Pryor of Arkansas in contests that will be crucial to determining control of the Senate. The spots laud the incumbents for protecting rural hospitals. The AHA is also making six-figure ad buys to support a pair of House Republicans, Reps. Dave Joyce of Ohio and Mike Simpson of Idaho, who are facing primary challengers.

Follow Paul Demko on Twitter: @MHpdemko

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