US health and human services secretary Kathleen Sebelius departed yesterday as the White House seeks to limit the political fallout from the rocky rollout of his signature healthcare law. Stakes are high in an election year, when Democrats are trying to retain control of the senate against Republicans still furious with the law.
Enrolment in the Affordable Care Act, the most sweeping piece of social legislation to pass the US Congress in a half-century, has risen to 7.5 million since people were given extra time following the March 31st deadline to sign up.
Despite the large numbers availing of cheaper health insurance under Obamacare, as it is popularly known, the botched early rollout marred Ms Sebelius’s tenure.
In a speech at the White House confirming her resignation, Mr Obama acknowledged the early problems last October with people seeking to sign up for health cover on the Healthcare.gov website.
Referring to their "long fight" to pass the 2010 law and resisting a Supreme Court challenge and ferocious political opposition since then, Mr Obama said: "She's got bumps, I've got bumps, bruises" but that the "final score" on the number who had signed up "speaks for itself".
Relations between Ms Sebelius and the White House became strained last year as technical problems caught Mr Obama and his advisers off-guard. They were left fire-fighting against Republicans as individuals were unable to sign up to new healthcare insurance and lost their existing policies.
Decision to leave
The White House has said Ms Sebelius's decision to leave was hers alone after five years in the health portfolio. Nominating his budget director Sylvia Mathews Burwell as his new health and human services secretary, Mr Obama said Ms Sebelius, a former Democratic governor of Kansas, had told him in early March she wanted to resign once the open enrolment period for Obamacare ended on March 31st.
The 2010 legislation was designed to extend health insurance to almost 50 million Americans estimated to be without coverage in a society with exorbitant healthcare costs where battling illness can leave patients with crippling bills and, for some, facing a choice of bankruptcy or death.
Republicans see the law as unnecessary over-reach by “big government” into healthcare and the lives of Americans, and a further shift towards a welfare state already lumbered with a mounting deficit. US residents face tax penalties next year if they fail to have some form of healthcare insurance.
The law was the contentious issue in the 2010 Congressional elections and the main reason so many conservative Republicans, particularly hardline Tea Party members, won seats and regained control of the House of Representatives in Mr Obama’s second year in the White House.
It has remained a divisive issue; Republicans forced a government shutdown last October in a bid to derail it.
Even though Mr Obama, lauding the number of people enrolling, declared the “debate over and that the legislation was “here to stay”, Republicans intend to make it the key issue in November’s elections.
Using a law that is unpopular with some voters, they are aiming to win six seats to retake the senate and put more obstacles in the way of Mr Obama’s progressive agenda.
Choosing Ms Burwell (48) marks a level of pragmatism on the president's part. The West Virginia native, who worked for the charitable arm of retailer Walmart and the Bill and Melinda Gates Foundation, was confirmed by the senate to run the White House budget office last year in a 96-to-0 vote.
The president will hope for the same cross-party support for Ms Burwell’s new job, though with Obamacare still a work-in-progress and remaining a highly divisive topic in an election year, her confirmation hearing will give his opponents a high-profile arena in which to continue their attacks.
