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Originally published Thursday, April 10, 2014 at 10:13 PM

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Kathleen Sebelius quits after rocky rollout of health law

Obama administration officials said Kathleen Sebelius made the decision to resign and was not forced out.

Tribune Washington Bureau and The New York Times

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WASHINGTON — Kathleen Sebelius, who helped guide the rocky and controversial rollout of President Obama’s landmark health-care law, has resigned as Health and Human Services secretary after more than five years.

Obama accepted Sebelius’ resignation this week, and Friday he will nominate Sylvia Mathews Burwell, director of the Office of Management and Budget, to replace her, officials said.

Officials said Sebelius, 65, made the decision to resign and was not forced out. But the frustration at the White House over her performance had become increasingly clear, as administration aides worried that the early problems at, the website set up to enroll Americans in insurance exchanges, would result in lasting damage to the president’s legacy.

Even last week, as Obama announced that enrollments in the exchanges had exceeded 7 million, Sebelius did not appear next to him for the news conference in the Rose Garden.

The president is hoping that Burwell, 48 — a Harvard- and Oxford-educated West Virginia native and former Bill & Melinda Gates Foundation official with a background in economic policy — will bring an intense focus and management acumen to the department. The budget office, which she has overseen since April 2013, is deeply involved in developing and carrying out health-care policy.

“The president wants to make sure we have a proven manager and relentless implementer in the job over there, which is why he is going to nominate Sylvia,” said Denis McDonough, the White House chief of staff.

Sebelius has acknowledged her management failures. “Let me say directly to these Americans, you deserve better,” she testified at a congressional hearing after the website rollout. “I apologize. I’m accountable to you for fixing these problems.”

In an interview Thursday, Sebelius said she had always known that she would not “be here to turn out the lights in 2017. My balance has always been, when do you make that decision?”

Last month, she approached Obama and began talking about her future, McDonough said. The secretary told the president that the March 31 deadline for sign-ups under the health-care law — and the rising enrollment numbers — provided an opportunity for change and that he would be best served by someone who was not the target of so much political ire, McDonough said.

Sebelius arrived in Washington, D.C., as a rising star, a Democratic governor from deeply red Kansas who also had an impressive health-care résumé as a respected former insurance regulator. She seemed to fit into an Obama team that put a premium on discipline.

Administration officials Thursday referred to the many successes during her tenure: the end to pre-existing conditions as a bar to insurance, the ability for young people to stay on their parents’ insurance and the reduction in the growth of health-care costs. In addition, Sebelius helped push through mental-health parity in insurance plans and worked with the Department of Education to promote early-childhood education.

The agency she ran helps provide health coverage to more than 100 million Americans through Medicare and Medicaid, and now through the insurance marketplaces created by the Affordable Care Act.

After the law passed in 2010, Sebelius and her aides worked to implement it under constant siege from Republicans on Capitol Hill, who tried to deny funding for the job. The agency ran into similar opposition in many Republican-led statehouses around the country.

Burwell is an alumna of the Clinton administration, where she worked as deputy director of the budget office from 1998 to 2001. She then worked for a decade at the Bill & Melinda Gates Foundation, part of the time as its chief operating officer. She most recently headed the Walmart Foundation, the philanthropic arm of Wal-Mart Stores.

Credited for her experience in and out of D.C., she was unanimously confirmed last year for the budget post, long considered one of the most important White House jobs. She is almost certain to face more opposition from Senate Republicans when she is nominated to replace Sebelius, as GOP lawmakers remain focused on derailing the 2010 Affordable Care Act. But a change in the filibuster rules will allow Democrats to confirm her with a simple majority.

Material from The Associated Press is included in this report.

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