There probably won't be many complaints about Burwell herself.
Burwell faces Congress for the first time as Obama's nominee to replace current health secretary Kathleen Sebelius when the Senate Health, Education, Labor and Pensions Committee holds its confirmation hearing. A hearing of the Finance Committee, which will vote on her nomination, hasn't yet been scheduled.
Burwell is familiar to Congress as director of the Office of Management and Budget, a job that placed her in the debate over the nation's fiscal trajectory and gave her authority over the government's regulatory apparatus. The Senate voted 96-0 less than a year ago to confirm her for OMB, and she has been meeting with senators to firm up support for the new position.
"We had a constructive and frank conversation that focused on the challenges of the president's signature domestic policy, Obamacare," Senator Orrin Hatch, a Utah Republican, said today in a statement after meeting with Burwell. He made clear the law, not Burwell, will be the focus of debate over her nomination.
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"From skyrocketing premiums to higher taxes and fewer choices — the adverse impacts on American families, seniors and job creators continue to mount on a daily basis," he said.
White House Experience
Burwell, 48, is a native of West Virginia and a Rhodes Scholar who served as deputy chief of staff to former President Bill Clinton. After he left office, she took a high-level job at the Bill & Melinda Gates Foundation, then was named president of the Wal-Mart Foundation in 2012. Obama nominated her to run the OMB in March 2013.
"Sylvia is a proven manager and she knows how to deliver results," Obama said at a April 11 event announcing her nomination for health secretary. "And she'll need to be a proven manager, because these are tough tasks, big challenges, you know, from covering more families with economic security that health insurance provides to ensuring the safety of our food and drug supply, to protecting the country from outbreak or bioterror attacks, to keeping America at the forefront of job- creating medical research."
Wide-Ranging Mission
Health and Human Services is the government's largest department, with a budget of about $1 trillion, including Medicare, the U.S. health plan for the elderly and disabled, and Medicaid, the program for the poor. Agencies such as the Food and Drug Administration, the National Institutes of Health and the Centers for Disease Control and Prevention also would fall under Burwell's auspices.
Republican senators have signaled they will focus much of their questioning on the Patient Protection and Affordable Care Act, the $1.4 trillion effort known as Obamacare to expand health insurance to most of the 48 million people in the U.S. without it. About 8 million people signed up for private coverage under the law this year, according to the government.
Republicans will question the law's impact on insurance premiums and the extent to which it has caused people with coverage to lose their plans or access to preferred doctors. In the past, Republican lawmakers also have vented frustrations over the Obama administration's unilateral changes to the law and its slow response to requests for information on enrollment and other issues.
Burwell has experience handling hostile opponents in public. Senator Jeff Sessions, an Alabama Republican, challenged her during a March 5 hearing on Obama's proposed budget, repeatedly demanding she answer "yes or no" to a question about whether the plan would violate spending limits.
Keeping calm, she repeatedly refused. "I think there are questions that are not simply yes or no questions," she said.
After she was nominated as health secretary, Sessions questioned her qualifications for the job and said that as OMB director, she "did more to obscure the nation's poor financial state than to illuminate it."
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