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.”
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