As I write this, news has just broken across the mainstream media that Kathleen Sebelius will announce tomorrow morning that she is resigning as Secretary of Health and Human Services, and that President Barack Obama will nominate Sylvia Mathews Burwell, Director of the federal Office of Management and Budget to replace her.
According to a report by ABC News’ Jeff Zeleny, “Sebelius approached President Obama about a month ago and asked to step down after the health care sign-up numbers were released, two senior administration officials and a confidante of Sebelius' told ABC News.
The White House always worried about finding someone to win confirmation at HHS,” Zeleny wrote on the abcnews.go.com website, “but Burwell was overwhelmingly confirmed as budget director with a vote of 96-0 about a year ago.”
Zeleny further stated in his report that “The President, while always fond of Sebelius, was furious at the rollout of the health care web site. He placed blame internally on her, aides said, among others. Publicly, however, President Obama stood by her through the embarrassment. ’Kathleen Sebelius doesn’t write code. She wasn’t our IT person,’ Obama said in an interview with NBC News on Nov. 7,” the Zeleny report noted.
Of course, it is always difficult to know how much to credit these insider political reports. Nonetheless, whatever the truth of the relations between President Obama and Secretary Sebelius, Sebelius’s resignation certainly comes at a delicate juncture in the longer-term trajectory of the implementation of the Affordable Care Act, just as many of the “internal healthcare system reform” changes are beginning to be robustly implemented, among them the mandatory readmissions reduction and value-based purchasing elements of the ACA.
Will Sebelius’s resignation create a political situation for the Obama administration, as it moves forward along a broad range of dimensions on healthcare reform? Only time will tell. At the same time, of course, Sebelius has been presiding over an agency (HHS) that is the umbrella over the Office of the National Coordinator for Health IT (ONC), and with Karen DeSalvo, M.D., still new-ish (as of January 13) in her position of National Coordinator, this is also a delicate moment for Dr. DeSalvo and ONC.
In the coming days, weeks, and months, the impact of the Sebelius resignation—if any—will become clear. With any luck, this development will not cast a cloud of uncertainty over the trajectories of healthcare reform and meaningful use, in a field already being jarred by multitudinous policy and industry jolts.