ACA marches on, despite Sebelius resignation

The change in leadership at the Department of Health and Human Services will have little effect on employers and the continued rollout of the Affordable Care Act.

The news of HHS Secretary Kathleen Sebelius’s resignation broke yesterday and while some in the benefits industry expressed surprise, others did not. Either way, the shuffle at the top of the department tasked with executing President Obama’s signature health care law will have little effect on the work employers need to get done.

“I tend to think that since the failed website implementation back in October, her resignation was somewhat inevitable. I think she did her best to wait it out until the initial enrollment period passed and they could get over that hurdle. Now seems like a natural time to transition to new leadership,” says Stephanie Vasconcellos, a lawyer with Neal, Gerber & Eisenberg LLP. “I don’t think it will have a significant effect on the rollout of the Affordable Care Act. I think this was just a good time to transition to someone new.”

For more on the resignation details see: Sebelius to resign as U.S. health secretary

For reaction from the benefits advising community see: Sebelius resignation brings hope to broker community

Larry Boress, president and CEO of the Midwest Business Group on Health, says he was somewhat surprised by Sebelius’s resignation “but I don’t know that the problems with the national marketplace website were necessarily her fault. But I guess somebody had to take the fall for that.”

Sebelius’s resignation will not likely affect the agency’s efforts to release further guidance related to the ACA. “I’m pretty confident that this will not impede the release of new guidance pertaining to the Affordable Care Act, says Bill Sweetnam, principal at Groom Law Group in Washington. “HHS has a smart team of lawyers working on regulations projects and a new leader at HHS should not impact those people.  So, as a benefits lawyer, I’m pretty sanguine about the news.”

Leaders of employer health care coalitions largely praised Sebelius and what she has accomplished during her tenure. “It's a tough job even without major changes going on, but with transformative changes in payment and delivery, the rollout of the exchanges, not to mention a very significant expansion of Medicaid, it's amazing that Secretary Sebelius stayed on for five years,” said Steve Wojcik, vice president, public policy with the National Business Group on Health.

Helen Darling, president and CEO of the NBGH, echoes Wojcik’s comments in an emailed statement. Sebelius “oversaw the largest, most comprehensive and most expensive changes in the role of the federal government in health care and health insurance in the history of the country,” she said. “With massive legislation which was passed by a divided Congress, partially vitiated by the Supreme Court and touched almost every corner of the $2.4 trillion health economy, she faced one of the biggest challenges ever and she took the heat and wrath with amazing toughness and resiliency and she did for so long for that kind of job.”

Boress, meanwhile, also applauded Sebelius’s efforts. “I think she was a strong advocate for health care in this country and changes that needed to be made in the way health care is delivered and paid [for] and clearly the access to care for people,” he says.

Sebelius’s replacement, Sylvia Mathews Burwell, will have a tough road ahead, cautions Vasconcellos, while emphasizing the change in leadership changes little for employers. “She is also going to have some hurdles ahead of her but I think it’s to her benefit that they’ve already done the initial open enrollment, the website has finally gotten through many of its big issues and now she’ll have a few months to get familiar with everything before the next open enrollment,” she says. “I don’t think this change will have a big impact on employers. It’s going to be business as usual for the Affordable Care Act.”

Burwell’s role, Vasconcellos believes, will largely just pick up where Sebelius leaves off. “I suspect Ms. Burwell’s role is going to be to keep things  moving, to roll out the employer mandate, to get up to speed for the next open enrollment so we don’t have the website issues like last year. I wouldn’t anticipate this would cause any big changes,” she says.

While noting he doesn’t yet know much about Burwell, Boress says the HHS is a huge organization and, as such needs a leader who is a great manager. “But the question is: Do they have the vision?” he says. “Like Don Berwick [former administrator of the Centers for Medicare and Medicaid Services] had, for example, or Sebelius. What they brought was something we hadn’t seen before – some real direction and vision.”

Gillian Roberts contributed to this report.

For reprint and licensing requests for this article, click here.
Healthcare plans
MORE FROM EMPLOYEE BENEFIT NEWS