Sebelius out at US Department of Health and Human Services

Kathleen Sebelius has resigned as the secretary of the Department of Health and Human Services. Her departure after a five-year tenure follows the disastrous rollout of the president’s signature domestic initiative, the Affordable Care Act (ACA). President Obama has nominated Sylvia Matthews Burwell, the current director of the Office of Management and Budget, to replace Sebelius as HHS head.

In remarks at the White House Friday announcing the shift, the president said that the “bumps” and “bruises” suffered by Sebelius and his administration in implementing the ACA notwithstanding, “What Kathleen will go down in history for is serving as the Secretary of the Health and Human Services when the United States of America finally declared that quality, affordable health care is not a privilege, but it is a right for every single citizen.”

Though Sebelius was clearly pushed out as damaged goods, the president attempted to put a positive spin on her leadership by claiming that despite the technically plagued launch last fall of the HealthCare.gov web site, what mattered most was the “final score” in people signing up for Obamacare. “There are 7.5 million people across the country that have the security of health insurance,” he said, “most of them for the very first time.”

Continuing on a theme he advanced Thursday in Austin, Texas, at the commemoration of the 50th anniversary of the Civil Rights Act of 1964, the president attempted to depict Obamacare as a historic advance that will better the social conditions of millions of Americans. In reality, the health care overhaul—which mandates individuals without insurance to purchase coverage from private insurers—cuts costs for government and corporations while boosting the profit margins of the insurance companies.

In her remarks on Friday, Sebelius described the Affordable Care Act as “the most significant social change in this country” since the enactment of Medicare and Medicaid nearly five decades ago. It is indeed significant, but not in the way the outgoing HHS secretary would have her audience believe. Specifically, the ACA undermines Medicare, the social health insurance program for seniors and the disabled, through proposed cuts of $700 billion over the next decade.

The Obama administration is committed to pushing forward with this regressive health care agenda, but without Sebelius at the HHS helm. During her tenure, she became the face of Obamacare and its botched rollout of HealthCare.gov, and faced numerous grillings on Capitol Hill from Republican and Democratic lawmakers over management issues at HHS in implementing the law.

While mismanagement, cronyism and incompetence were clearly involved in the disaster overseen by Sebelius at HHS, the problems were not purely technical in nature. More fundamentally, they were bound up with the irrational structure of Obamacare, which keeps the class-based health care system in place and subordinates the provision of medical care to the drive for profit. The high premiums and deductibles carried by the most inexpensive plans found on the ACA exchanges are a function of this structure.

The horrendous user experience suffered by uninsured people visiting the HealthCare.gov site—and the poor quality of the policies offered for sale—are a reflection of the contempt of the administration and its functionaries for the general population. While Obama claimed his health care plan would provide “near universal” access to quality health care, the 7.5 million people that have signed up for coverage are cynically seen by the White House as the statistical success to make the program more politically palatable.

Sebelius’s replacement is a crass political maneuver by the White House aimed at damage control in advance of the mid-term elections, in which the Republicans will seek to capitalize on the growing unpopularity of Obamacare. A recent USA Today/Pew Research Center Poll finds that 50 percent of Americans disapprove of the ACA, while only 37 percent approve. That the Republicans can posture as the champions of Americans’ health care in opposition to Obamacare is testament to the reactionary character of the legislation.

Obama’s nominee to replace Sebelius, White House budget director Sylvia Burwell, is a veteran of the Clinton administration and the Treasury Department with close ties to the corporate world. She has served as a key aide to Microsoft founder Bill Gates, as president of the Walmart Foundation, and as a member of the board of the MetLife insurance company.

In his remarks Friday, President Obama praised Burwell as a “proven manager” who can cut costs. He argued that “in the year since she arrived [as budget director], the deficit has plunged by more than $400 billion.” Obama hopes that her nomination will signal his administration’s commitment to reining in government spending, both in health care and across the board.

Commenting to the Wall Street Journal on the nomination of a new HHS secretary, Maya MacGuineas, president of the Committee for a Responsible Federal Budget, said, “It makes sense the [Obama] administration would want to have her focus on the area they are so passionate about.”

House Budget Committee Chairman Paul Ryan (Republican of Wisconsin), hailed Burwell’s nomination for budget director last year, saying that she “has led an impressive career in both the public and private sectors. She has firsthand experience in budgeting responsibly.”

Signaling her openness to making changes to the Medicare and Medicaid programs with bipartisan agreement, she acknowledged at a recent Senate hearing that health care costs are “one of the fundamental drivers of the deficit.” Rep. Ryan’s budget proposal calls for instituting “premium support,” or a voucher system, in Medicare.

As HHS secretary, Sylvia Burwell would preside over not only Obamacare, but the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health, among others. The department has 78,000 employees. Her nomination must be approved by the US Senate.