Two-term Kansas Governor Kathleen Sebelius became the nation's new Department of Health and Human Services (HHS) secretary with a 65-31 Senate confirmation vote on April 28. Democrats urged her approval so that a new health chief could immediately begin leading the federal response to the deadly swine flu outbreak. Sebelius was expected to get the 60 votes needed for approval in the Democratic-led Senate, despite opposition to her right-to-choose record on abortion and her failure to pay $7,000 in taxes on time.
Anti-abortion groups lobbied Republican senators to vote against Sebelius, criticizing her stances on the incendiary issue and her ties to a late-term abortion doctor who donated to her campaigns. Sebelius initially underreported to senators the size of those donations, though she apologized and said it was an inadvertent error.
Republican opponents cited Sebelius' pro-abortion stances and raised concerns about whether Obama administration plans to overhaul the nation's healthcare system would cut out Republicans and lead to rationing of care. "She is the wrong appointee for this particular assignment," said Sen. Robert Bennett, R-Utah. "She has backed a partisan process for health care reform. She has refused to support patient safeguards."
As the first of 20 HHS officials requiring Senate approval to clinch her job, Sebelius starts work without much of a team in place. The Senate hasn't acted on Obama's nominees for deputy HHS secretary or commissioner of the Food and Drug Administration, and Obama has yet to nominate people for other key jobs, including surgeon general and assistant secretary for preparedness and response. There's also not been an appointment for head of the Centers for Disease Control and Prevention, another component of the massive HHS, which has 65,000 employees and a $750 billion budget.
Obama was dealt a setback to his cabinet nomination process when his first pick for HHS secretary, former Sen. Tom Daschle of South Dakota, withdrew in February over unpaid taxes. Sebelius is the last of Obama's cabinet nominees awaiting confirmation.
Though the swine flu will be an immediate focus, Sebelius will also be charged with shepherding Obama's overhaul of the nation's $2.5 trillion healthcare system to reduce costs and cover some 50 million uninsured Americans. Healthcare IT industry leaders have long been awaiting the confirmation, as so many decisions hinge on the next HHS secretary. This includes a definition for the American Recovery and Reinvestment Act's (ARRA) "meaningful use" of healthcare IT clause, which will determine whether hospitals and physician practices qualify for certain monetary incentives from the government.
Sebelius will be responsible for more than $100 billion allocated for healthcare in the stimulus package. ARRA includes $87 billion for Medicaid, $39 billion for COBRA and $1.1 billion for federal research on comparative healthcare effectiveness. In testimony before the Senate Finance Committee on April 2, Sebelius said the economic stimulus package makes positive investments now that will yield health and economic dividends later. "Through health information technology, it lays the foundation for a 21st century system to reduce medical errors, lower healthcare costs and empower health consumers," Sebelius said. "In the next five years, HHS will set the standards for privacy and interoperability, test models and certify the technology and offer incentives for hospitals and doctors to adopt it."