With a hug and a kiss, President Barack Obama said goodbye to his troubled Health and Human Services Secretary, Kathleen Sebelius, on Friday, thanking her for her friendship and wit and taking note of her none-too-gentle battles with Congress.
The White House announced on Thursday night that Sebelius would resign after serving five years as head of the agency that takes care of health policy, food safety, fighting disease and medical research.
She’ll be replaced by the current director of the White House Office and Management and Budget, Sylvia Mathews Burwell.
Sebelius, Obama said, “will go down in history for serving as HHS when United States of America finally declared that quality affordable health care is not privilege but right for every single citizen of these United States of America.”
A former governor of Kansas who had also been the state’s insurance commissioner, Sebelius helped oversee the hasty writing and rollout of the 2010 Affordable Care Act, an ambitious piece of legislation that has been fought at every twist and turn by Republicans in Congress, governors of conservative states, insurance companies and employers.
The challenges went right up to the Supreme Court, forcing teams at HHS to try to write the rules for implementing the law even as they wondered whether it would even take effect.
It seeks to get health insurance to more than 45 million Americans who don’t have it, tries to lower health care costs and to improve how service is coordinated among primary care doctors, specialists, hospitals and clinics.
Besides that, HHS battled the H1N1 swine flu pandemic, dozens of outbreaks of food poisoning, an epidemic of fungal meningitis linked to poorly regulated compounding pharmacies, debates over stem cell research and questions about a woman’s right to birth control.
“She's got bumps, I've got bumps, bruises,” Obama said Friday morning as spring finally came to the White House Rose Garden. “But we did it because we knew of all the people we've met all across the country who had lost a home, had put off care, had decided to stay with a job instead of start a business because they were uncertain about their health care situation.”
The reward for all that work was the horrific debut of HealthCare.gov, the web-based marketplace that was supposed to look like Travelocity.com but that instead crashed and burned for the first two months.
Sebelius and Obama took much of the blame, but experts also pointed to poor project management and a clunky federal contracting process that forces agencies to take low bids and work with trusted partners who may not be up to speed with the best technology and practices.
Obama noted this and praised Sebelius for sticking it out.
“Under Kathleen's leadership, her team at HHS turned the corner, got it fixed, got the job done and the final score speaks for itself — there are 7 and a half million people across country that have security of health insurance, most of them for the very first time and that's because of the woman standing next to me here today and we are proud of her for that,” Obama said. “That's an historic accomplishment.”
There was one last glitch for the road. Sebelius lost one page of her brief farewell speech in the Rose Garden and was forced to ad-lib.
Sebelius, silver-haired, thin and elegant, is different in physical appearance from her successor, but perhaps not in her ability to stay calm despite often theatrical attempts to throw a cabinet officer off balance in Congressional hearings and on cable television shows.
"I will miss her advice. I will miss her friendship. I will miss her wit. But I am proud to nominate someone to succeed her who holds these traits in abundance,” Obama said.
Burwell, 48, came back to the White House a year ago from the Walmart Foundation, the charitable arm of the king of big box stores. Before that, Burwell worked for the Bill and Melinda Gates Foundation and in President Bill Clinton's administration under then-Treasury Secretary Robert Rubin.
Diminutive, sometimes rumpled but with a ravishing smile, Burwell called the bluff of a battling Congress and ordered the shutdown of the federal government, from panda-cams to national parks, when it failed to pass a budget.
"Sylvia is a proven manager and she knows how to deliver results," Obama said. He noted she will need them to see through the implementation of the Affordable Care Act, adding that she will need those skills managing the health care law and other HHS responsibilities: "These are tough tasks — big challenges."
Burwell, who comes from West Virginia, is the daughter of a small-town mayor. “She brings the common sense that you see in small towns,” Obama said. “She sees the values that you bring in caring about your neighbor. She’s a proven manager and knows how to deliver results.”
Senate Minority Leader Mitch McConnell, R-Ky., said he hopes Burwell's nomination will be "the start of a candid conversation about Obamacare's shortcomings and the need to protect Medicare for today's seniors, their children and their grandchildren."
Other Republicans wasted no time in thumbing her noses at Sebelius, and promising the acrimony will not end. "Secretary Sebelius oversaw a disastrous rollout of ObamaCare, but anyone can see that there are more problems on the way,” said Republican National Committee Chairman Reince Priebus.
“If I could take something along with me, it would be all the animosity,” Sebelius told the New York Times in an interview.