Senators quizzed President Barack Obama's pick for the crucial post on the botched rollout of HealthCare.gov, morale problems within the $1 trillion federal agency and the specter of increasing insurance premiums. But the focus during the hearing before the Committee on Health, Education, Labor and Pensions was primarily on concerns about implementation of the Patient Protection and Affordable Care Act rather than on Burwell's competency for the post. And two veteran Republicans senators, John McCain of Arizona and Richard Burr of North Carolina, indicated that they would vote in favor of her confirmation.
Reform Update: HHS nominee Burwell draws little hostility at confirmation hearing
Burwell was approved for her current post as director of the Office of Management and Budget by a 96-0 vote last year. The 49-year-old West Virginia native's resume also includes serving as president of the Walmart Foundation, chief operating officer at the Bill and Melinda Gates Foundation and several key positions in President Bill Clinton's administration.
Burwell still faces a second hearing before the Senate Finance Committee before her nomination can be taken up by the full Senate. That hearing has not been scheduled, but is expected to occur before the end of the month. If confirmed as expected, Burwell will replace Kathleen Sebelius, who announced her resignation last month after five years as the top HHS official.
Sen. Lamar Alexander (R-Tenn.), the ranking minority member of the committee, quizzed Burwell on whether she would support Republican-backed proposals such as allowing sale of health insurance policies across state lines and permitting wider availability of low-cost catastrophic plans.
“You have a reputation for competence,” Alexander said. “I would respectfully suggest you're going to need it.”
Sen. Pat Roberts (R-Kan.) questioned whether Obamacare is simply an interim step toward a universal, single-payer healthcare system. Sen. Barbara Mikulski (D-Md.) raised concerns about employee morale at the agency given chronic budget uncertainties. Sen. Lisa Murkowski (R-Alaska) bemoaned rising premiums in her home state, indicating that Alaska has the second highest health insurance costs in the country.
“We have not worked to reduce the cost of healthcare, which we must do,” Murkowski said. “The financial burden for our families is such that they're looking at this and saying I'm better off paying the fines.”
The most unusual (and parochial) line of questioning came from Sen. Johnny Isakson (R-Ga.). He wanted to know what Burwell was doing in her current post at OMB to expedite approval of funding for the harbor expansion project in Savannah, Ga.
Burwell largely stuck to brief and innocuous answers during the two-hour session. She promised that the agency would be transparent and accountable under her stewardship. She also defended the Obama administration's use of regulatory authority to make adjustments to the federal healthcare law, which many Republicans have complained is an abuse of executive power.
“What we're trying to do is common-sense implementation within the law,” Burwell said. “That is the objective.”
A comprehensive database detailing the costs and benefit rules associated with all health plans sold on the state and federal exchanges in 2014 has been created by the Robert Wood Johnson Foundation and Breakaway Policy Strategies. It includes information on premiums, deductibles, out-of-pocket limits and network composition.
Researchers have also written an analysis of what their scrutiny of the plans revealed. Among the takeaways: The average monthly premium (not including federal subsidies) nationwide for a silver plan, which is designed to cover 70% of medical costs, was $265 for a 27-year-old, $435 for a 50-year-old and $878 for a family of four.
Blue Cross and Blue Shield of North Dakota fired its president and CEO, Paul von Ebers, on Monday after the company lost $80 million last year. The financial bloodletting stemmed primarily from a subsidiary, Noridian Healthcare Solutions, that was the lead contractor in building Maryland's disastrous exchange website. The project reportedly resulted in a $51 million loss for Noridian and the company was fired.
Follow Paul Demko on Twitter: @MHpdemko
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