Assuming she can survive what is likely to be a confirmation hearing circus, OMB Director Sylvia Mathews Burwell will soon replace Kathleen Sebelius as the Secretary of Health & Human Services, with responsibility for further implementing the Affordable Care Act. The White House insists that Sebelius submitted her resignation without any prompting, which is likely true. But that doesn’t mean she is leaving on fantastic terms.

Nonetheless, the White House is promoting the fact that she overcame the initial problems with the website and actually exceeded enrollment expectations and goals. Basically, they’re saying that Sebelius oversaw the HHS Department at a time when approximately ten million people got access to health care they would not otherwise have, and her critics cannot claim to have done anything of similar merit.

That’s a fair point, but it glosses over the lasting damage done to how the law is perceived, and Sebelius bears responsibility for that.

She she will leave with an imperfect record that she can still be proud of.

As for Ms. Burwell:

The president is hoping that Ms. 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 department. 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 R. McDonough, the White House chief of staff.

And the Republicans will surely give her a fair and dignified hearing.

Martin Longman

Martin Longman is the web editor for the Washington Monthly. See all his writing at