Obama shuffles deck to cement health law gains

by Stephen Collinson

President Barack Obama on Friday nominated budget director Sylvia Mathews Burwell as his new health secretary, seeking to capitalize on an enrollment surge to cement his signature health law.

Obama paid tribute to outgoing Health and Human Services Secretary Kathleen Sebelius, saying she had pulled off a "historic accomplishment" by securing health insurance for millions of Americans for the first time.

Despite Obama's warm endorsement, Sebelius is effectively paying the price for the chaotic rollout of Obamacare last year, which forced the administration to launch an emergency effort to fix a malfunctioning enrollment website.

The hurried triage paid off, after 7.5 million people eventually signed up through federal and state exchanges to the health care plan by an end-of-March deadline.

"Kathleen will go down in history for serving ... when the United States of America finally declared that quality affordable health care is not a privilege but it is a right for every single citizen of these United States of America," Obama said.

The president praised Sebelius for sticking with her job "when it got rough. She's got bumps. I've got bumps, bruises," he said.

Sebelius, an original member of Obama's cabinet, said that she had known all along that her job would be tough.

"We are on the front lines of a long overdue national change, fixing a broken health system," she said in an event with the president surrounded by pink cherry blossoms in the White House Rose Garden.

"There is a reason that no earlier president was successful in passing health reform despite decades of attempts," she said.

Obama's success in passing the Affordable Care Act (ACA) was undeniably a historic achievement as it is the most sweeping social reform legislation to come into force in 50 years.

But he has been deprived of a political payoff from the law, as its popularity is still in question, there have been repeated glitches in implementing it and Obamacare is a millstone for Democratic candidates seeking re-election in conservative states, who face a buzzsaw of opposition from Republicans.

Mathews, who has a reputation inside the White House for quiet managerial competence, faces a challenge in smoothing out implementation in time for the next enrollment period later this year.

Republicans are also certain to use her Senate confirmation process to revive controversy over Obamacare, which they insist must be repealed, arguing it costs jobs and represents an unacceptable overreach by government into the private lives of Americans.

"I hope this is the start of a candid conversation about Obamacare's short-comings," said Senate Republican minority leader Mitch McConnell.

The ACA, which Obama signed into law after a protracted political battle in 2010, seeks to provide quality health insurance in the US private market for millions of Americans who lack it.

It provides federal or state regulated insurance exchanges and subsidies for those who previously could not afford health care—and imposes a fine on those who decline to buy it.

The law includes some popular aspects, including a provision which prevents insurance firms from depriving coverage to Americans with pre-existing health conditions.

But the law's credibility was hit by rollout glitches, including Obama's now discredited statement that anyone who liked their pre-existing health care plans could keep them.

The White House apparently decided that the end of the sign-up period on March 31 marked an appropriate time for Sebelius to move aside.

Sebelius "thought that it was time to transition the leadership to somebody else," White House Chief of Staff Denis McDonough told the New York Times.

"She does hope—all of us hope—that we can get beyond the partisan sniping."

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