WASHINGTON - Kathleen Sebelius, the health and human services secretary, is resigning, ending a five-year tenure marred by the disastrous rollout of President Barack Obama’s signature legislative achievement, the Patient Protection and Affordable Care Act.
Obama accepted Sebelius’ resignation this week. This morning he will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, who has Arkansas ties, to replace Sebelius, officials said.
The departure comes as the Obama administration tries to move beyond its early stumbles in carrying out the law.
It is working to convince a still-skeptical public of the law’s lasting benefits and help Democratic incumbents, who face attack ads after supporting the legislation, survive the midterm elections this fall.
Officials said Sebelius, 65, made the decision to resign and was not forced out. But the frustration at the White House over her performance had become increasingly clear over worry that the problems at healthcare.gov, the website set up to enroll Americans in insurance exchanges, would result in last-ing damage to the president’s legacy.
Last week, as Obama announced that enrollments in the exchanges had exceeded 7 million, she did not appear next to him for the news conference in the Rose Garden.
The president is hoping that Burwell, 48, a Harvard- and Oxford-educated West Virginia native with a background in economic policy, will bring an intense focus and management acumen to the Health and Human Services Department.
Burwell worked for Bill Clinton’s presidential campaign in Little Rock in 1992. Throughout Clinton’s two terms, Burwell served as chief of staff at the Treasury Department, special assistant to the president for economic policy and White House deputy chief of staff.
After working in the White House and at the Bill and Melinda Gates Foundation, she returned to Arkansas in January 2012 for a one-year stint as president of the Wal-Mart Foundation.
The budget office, which she has overseen since April of last year, is deeply involved in developing and carrying out health-care policy.
“The president wants to make sure we have a proven manager and relentless implementer in the job over there, which is why he is going to nominate Sylvia,” said Denis McDonough, the White House chief of staff.
Last month, Sebelius approached Obama and began a series of conversations about her future, McDonough said. The secretary told the president that the March 31 deadline for sign-ups under the health care law - and rising enrollment numbers - provided an opportunity for change and that he would be best served by someone who was not the target of so much political ire, McDonough said.
“What was clear is that she thought that it was time to transition the leadership to somebody else,” he said. “She’s made clear in other comments publicly that she recognizes that she takes a lot of the [criticism]. She does hope - all of us hope - that we can get beyond the partisan sniping.”FIERCE HEALTH-CARE ADVOCATE
The resignation is a low point in what had been a successful career for Sebelius, who as governor of Kansas was named by Time magazine as one of the five best governors in the country and was mentioned as a possible running mate for Obama in 2008.
The two had bonded when Sebelius endorsed his presidential bid early in 2008, becoming one of the highest-profile Democratic women to back him over Sen. Hillary Rodham Clinton and helping him deliver a big win in the Kansas caucus.
White House officials were quick to point out the many successes during Sebelius’ tenure: the end to pre-existing conditions as a bar to insurance, the ability for young people to stay on their parents’ insurance and the reduction in the growth of health-care costs.
In addition, Sebelius helped push through mental-health parity in insurance plans and worked with the Department of Education to promote early-childhood education.
Sebelius said Thursday that she always knew she would not “be here to turn out the lights in 2017.”
“My balance has always been, when do you make that decision?” she added.
The president had been under pressure for months to fire Sebelius. But he had resisted, in part because he did not want the Department of Health and Human Services to undergo more upheaval in all the problems plaguing healthcare.gov.
As recently as last week,Jay Carney, the White House press secretary, rejected any suggestion that Sebelius would be fired.
McDonough on Thursday praised Sebelius as “a fierce advocate” and said she had been “tenacious in her belief” in the president’s health-care law.
“She’s fearless in her defense of this idea at the heart of the Affordable Care Act,” he said. “The president has commented to me countless times how much he admires that.”
In addition to the political battles over the passage and carrying out of the Affordable Care Act, Sebelius clashed with conservatives over contraception and faced frequent calls for her political head by Republicans after the healthcare website failed to function properly last year.
In hearings on Capitol Hill, Sebelius sometimes grew rattled under grillings by lawmakers. In one hearing at the end of October, Sebelius declared that healthcare.gov “has never crashed.”
“It is functional,” she added, “but at a very slow speed and very low reliability, and has continued to function.”
She made that statement even as large screens in the hearing room showed a live shot of the website with a page that said: “The system is down at the moment. We are experiencing technical difficulties and hope to have them resolved soon.”
An appearance on The Daily Show With Jon Stewart in October went even worse. Stewart challenged her to “sign up for Obamacare” before he could download every movie ever made.
“We’ll see which happens first,” he joked as she struggled to defend the website and the health-care law.
The television appearance prompted headlines like “Kathleen Sebelius’s Daily Show Disaster” and accusations from Republicans that she was being misleading. Democrats squirmed at her stiff and halting performance,which did little to inspire confidence in the website’s performance - or her own.
After the poor public performances, her national television exposure has been limited, but she has continued to make small appearances and has been active on Twitter to press for people to sign up for insurance.
Sebelius said she hoped - but did not expect - that her departure would represent the beginning of a more cooperative period in Washington to make health care better.
“If I could take something along with me … all the animosity,” she said. “If that could just leave with me, and we could get to a new chapter, that would be terrific.”
7.5 MILLION ENROLLMENT
Earlier Thursday, Sebelius said about 400,000 people signed up for private health insurance under the law since a deadline passed that was initially supposed to end enrollment.
While the official enrollment period ended March 31, the Obama administration said that people who tried to sign up before the deadline would have until next Tuesday to complete their applications. The late enrollees take the total number to about 7.5 million in private health plans, Sebelius said at a Senate hearing.
The total enrollment eclipses a Congressional Budget Office estimate of 7 million set last year.
Sen. Orrin Hatch, R-Utah, questioned the administration’s coverage figures, noting that it’s not known how many of the people who’ve signed up have actually sealed the deal by paying the first month’s premium, or how many already had health insurance before the law went into effect.
“So far, it appears that the administration is hoping that the public will ignore these important questions and only focus on the number of claimed enrollees,” Hatch said.
The Blue Cross Blue Shield Association says that 80 percent to 85 percent of the people who had enrolled with Blues plans through the health insurance exchanges had paid their premiums as of Feb. 1, which would represent a significant reduction over the administration’s raw numbers.
Sebelius said a Rand Corp. study released this week estimated that 9.3 million people had gained insurance under the law, including through new private plans sold through insurance exchanges and an expansion of Medicaid in about half the states.
“I do not have data to give you right now in terms of who exactly was previously uninsured,” Sebelius said Thursday. “We are collecting that.”
Hatch also criticized the administration’s spending to begin the law. He said the government spent $736 million advertising the new insurance programs, and $1.3 billion in total, including the costs of setting up the federal healthcare.gov website and call centers to provide phone assistance to those signing up.
“These are enormous sums of money” given the number of people enrolled, he said.
Information for this article was contributed by Michael D. Shear of The New York Times; by Alex Wayne of Bloomberg News; by Erica Werner and Ricardo Alonso-Zaldivar of The Associated Press; and by the Arkansas Democrat-Gazette.
Front Section, Pages 1 on 04/11/2014