Sebelius to leave HHS

WASHINGTON - Health and Human Services Secretary Kathleen Sebelius will step down Friday and President Obama will nominate his budget chief as her successor, White House officials confirmed Thursday, marking an end to the secretary's tumultuous five-year tenure.

Sebelius entered the cabinet as a well-regarded former governor of conservative Kansas, but came under intense fire in the fall during the botched rollout of the Affordable Care Act. Obama made it clear to his aides at the time that he would not seek her resignation, although several Democrats had argued privately that someone should be held accountable for the problems with the federal health insurance exchange.

Sebelius remained a tireless promoter of the health-care law over the last six months, urging uninsured Americans to sign up on state and federal exchanges. Traveling to major cities such as Miami, Phoenix, and Houston to reach residents whose Republican governors opposed the law, she held 43 local events and more than 100 local interviews.

Obama will nominate Sylvia Mathews Burwell, director of the Office of Management and Budget, to take Sebelius' place. Although Burwell does not have an extensive background in health-care policy, she is known for her strong management skills and is popular on Capitol Hill. The Senate confirmed her as OMB director 96-0 a year ago.

Bloomberg News and the New York Times first reported the news of Sebelius' resignation Thursday night.

According to a White House official, Sebelius notified Obama in early March that she planned to leave. "At that time, Secretary Sebelius told the president that she felt confident in the trajectory for enrollment and implementation of the Affordable Care Act, and that she believed that once open enrollment ended it would be the right time to transition the department to new leadership," said the aide, who spoke on the condition of anonymity to discuss internal deliberations.

Other officials said Sebelius timed the conversation with Obama to a moment when she believed that the enrollment troubles had turned around.

Senior Democrats on Capitol Hill appeared to be caught off guard by the announcement. But House Minority Leader Nancy Pelosi (D., Calif.) praised Sebelius' service.

"From day one, Secretary Kathleen Sebelius has remained laser-focused on a single purpose: to make health care a right, not a privilege, for all Americans. Her leadership has been forceful, effective, and essential," Pelosi said in a statement.

Although Sebelius is best known as the public face of the Affordable Care Act, her work spanned issues from the H1N1 virus to childhood obesity to parity for mental health treatment.

Congressional Republicans said the larger problem was not Sebelius' implementation of the law but the legislation itself.

"Secretary Sebelius was asked to promote something unready, poorly structured, and unpopular," Sen. Charles E. Grassley of Iowa said in a statement. "She was given a law that was just about written in pencil the way the deadlines changed all the time. That put her in a position of having a strained relationship with Congress. It's disingenuous for the White House to distance itself from the problems and attribute them to partisan sniping at one member of the administration. The next secretary might have a fresh start with the public and Congress but the flawed law is still the law."

Despite the troubled launch of HealthCare.gov, which left many consumers unable to access the federal exchange for nearly two months, the administration managed to meet its initial goal of enrolling 7 million Americans during its initial sign-up period. On Thursday, Sebelius announced that about 7.5 million consumers had enrolled, although those who don't pay their premiums will not be insured.

In the fall, Sebelius proved steely under harsh congressional questioning, telling her Republican critics that they could blame her for the website's problems.

"Access to HealthCare.gov has been a miserably frustrating experience for way too many Americans," she said in her opening statement before the House Energy and Commerce Committee in late October. "So let me say directly to these Americans: You deserve better. I apologize. I'm accountable to you for fixing these problems. And I'm committed to earning your confidence back by fixing the site."

Other senior administration officials played central roles in helping repair the website and steer the law's implementation after the rollout. Jeffrey Zients, a former OMB official who directs the National Economic Council, rejoined the administration to spearhead a team of federal employees and contractors who worked to repair HealthCare.gov. Phil Schiliro, chief legislative liaison in Obama's his first term, returned in December to oversee the policy side of the law.

Sebelius was confirmed on April 28, 2009. Her tenure - 1,808 days as of Thursday - is about 500 days longer than the average for HHS secretaries, dating to the Carter administration.