Tags: Healthcare Reform | Kathleen Sebelius | Sylvia Mathews Burwell | obamacare | replacement

OMB Head Sylvia Mathews Burwell in Line to Replace Sebelius

Image: OMB Head Sylvia Mathews Burwell in Line to Replace Sebelius

By Cathy Burke and Todd Beamon   |   Thursday, 10 Apr 2014 10:46 PM

The woman to be named to occupy the hot seat vacated by Health and Humans Services Secretary Kathleen Sebelius will have an uphill battle from Day One.

Sylvia Mathews Burwell, director of the Office of Management and Budget, faces a grueling nomination process with the 2014 elections just months away, Town Hall predicted.

And while she's no stranger to butting heads with Republicans, the GOP is ready.

"Ms. Burwell will be nominated to lead one of the most important jobs in government," Senate Minority Leader Mitch McConnell said in a statement.

"And I hope this is 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."

The Washington Examiner reported Thursday night that Sebelius' successor will be able to determine when the open enrollment period for the Obamacare exchanges can begin or end, what type of insurance every American must have, and what constitutes enough of a hardship to exempt individuals from the mandate to purchase coverage.

And noting Sebelius could "push the boundaries of her discretion to delay or modify key parts of the law without seeking congressional authorization," lawmakers will be itching to reign that power in, the Examiner reported.

"The challenge for Ms. Burwell, or any other successor, is to help Congress find the right way to repair the damage Obamacare has done to American families," said Tennessee's Sen. Lamar Alexander, the top Republican on the Senate health committee, calling President Obama's pick "the right decision."

He also made it clear the switch would hardly mean an end to GOP pressure on the law.

For most of her government career, Burwell has flown under the media radar.

It was her tersely written email that initiated last October's government shutdown, NBC News reported.

And more than a dozen years earlier, as a deputy to the OMB director in the Clinton administration, she challenged Republicans who delayed spending bills in 2000, declaring: "We will sign short-term [continuing resolutions] as long as it takes to get the job done," The Wall Street Journal reported at the time.

The Harvard- and Oxford-educated Burwell, who is married and has two children, has built an impressive resume in government and fiscal policymaking, learning at the feet of President Bill Clinton and his Treasury Secretary, Robert Rubin, The Washington Post reported in a profile last year.

She joined the Clinton campaign in 1992 and led his economic transition team after the election. She then landed the job of staff director of the National Economic Council the next year.

In 1995, she served as Rubin's chief of staff when he was at Treasury, and two years later moved back to the White House to serve as one of Clinton's two deputy chief of staffs.

Burwell landed at OMB as Jack Lew's deputy director from 1998 to 2001, when Bill Gates recruited her to head the Global Development Program at the Bill & Melinda Gates Foundation. In 2011, she became president of the Wal-Mart Foundation, which focuses on ending hunger in the U.S.

It was her loyalty in the Clinton administration that impressed many – even during the Monica Lewinsky sex scandal.

"I made a decision that I believed, and do to this day, that while President Clinton made a mistake, that the contributions he made to this country and the important changes are so profound that I would continue to serve, and serve with my head held high," she told the Seattle Times in 2007.

Like Clinton, Burwell grew up in a small Southern town – Hinton, W. Va. – and became a Rhodes Scholar.

She told the Seattle Times that Clinton is one of the people who inspires her the most, along with Rubin "who was never hierarchical, who always reached into an organization to hear directly from people," and Clinton's former chief of staff Erskine Bowles, "who taught me you attract more bees with honey."

She said Clinton's inspiration was due to his "dedication to public service."

But Rubin started her economic policymaking career, according to a 1999 Washington Post profile.

He told the newspaper when he working on Wall Street, he never reached senior aides in the Clinton campaign team, but "could always get results" talking with Burwell.

During her first OMB stint in the Clinton administration, Burwell was "part of a team that presided over three budget surpluses in a row," President Obama said when he nominated her at the White House in March 2013 for the director job, NBC News reported. "So Sylvia knows her way around a budget."

But it was her Walmart Foundation stint that worried some.

"Obviously Walmart has a lot of interests in, say, labor rights that are not in alignment with the best interests of the country. If she shares those views that would be an issue," Dean Baker of the Center for Economic Policy & Research said at the time, NBC News reported.

Reuters contributed to this report.

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