“Maybe this is a good point to make the transition, given that the enrollment for 2014 is just finished,” said Paul Ginsburg, a health policy expert at the Price School of Public Policy at the University of Southern California. “It finished on a high note despite all the problems experienced since the beginning. If a change was going to be made, this seems like a pause to make a change like that.”
Sebelius will be replaced by Sylvia Mathews Burwell, who currently serves as director of the Office of Management and Budget. The change was first reported by the New York Times.
Burwell, a veteran of the Clinton administration, was named OMB director in April last year, joining the White House after a year as president of the Walmart Foundation. Before that she was president of the Global Development Program at the Bill and Melinda Gates Foundation. She held several positions in the Clinton White House, including deputy OMB director.
During the past six months, Sebelius became the public face of Obamacare's troubled rollout and a frequent piñata for Republican critics. There were calls for her resignation almost as soon as the exchanges opened for business on Oct. 1.
“It's a little overdue,” said Joseph Antos, a health policy expert at the conservative American Enterprise Institute. “Somebody who was an actual appointee, as opposed to a mere career bureaucrat, needed to take responsibility for the problems of the website. Logically within HHS the person on top is the one who is ultimately responsible.”
As with seemingly every aspect of Obamacare, opinions of Sebelius's stewardship vary dramatically. Timothy Jost, a supporter of the law and a professor at Washington and Lee University School of Law, points to provisions of the law that she has successfully implemented, most notably prohibiting discrimination by insurers based on pre-existing conditions.
“I think Sebelius has done on the whole a good job in an almost impossible situation, trying to implement a very, very complex law in the face of determined and hostile political opposition,” Jost said. “Under the best of circumstance it would have been incredibly difficult to implement.”
During Sebelius's tenure, HHS changed or delayed numerous provisions of the Patient Protection and Affordable Care Act. The agency postponed the requirement that employers with 50 or more employees offer coverage to their workers until at least 2015. It also allowed low-cost insurance plans that don't meet the law's coverage requirements to be renewed for up to three years beyond when they were supposed to be pulled from the market. Republicans repeatedly questioned whether the administration had the authority to make such broad changes to the law.
“Secretary Sebelius had one of the toughest jobs in Washington—implementing Obamacare, a flawed law that continues to fall woefully short of its promises to the American people,” Sen. Orrin Hatch (R-Utah), the ranking minority member of the Senate Finance Committee, said in a statement. “While we haven't always agreed, Secretary Sebelius did the best she could during the tumultuous and volatile rollout of the law.”
While Sebelius became among the most high-profile members of the Obama administration during the implementation of the contentious law, she may be relegated to a footnote in the future. “Like most secretaries of HHS, she too will be forgotten,” Antos said.
Obama nominated Sebelius to lead HHS after his first choice for the position, former Sen. Tom Daschle withdrew his name amid controversy involving his taxes. Sebelius was governor of Kansas from 2003 to 2009 and previously served as the state's insurance commissioner. During the 2008 campaign, she was often talked about as a possible running mate on the Democratic ticket with Obama.
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