Barack Obama sought to draw a line under one of the most calamitous chapters of his presidency on Friday, announcing the resignation of his embattled health secretary, Kathleen Sebelius, and claiming that his flagship health reforms have finally “turned a corner”.  Signalling the White House's intention to move on from the rollout of the laws introduced under the Affordable Care Act, which was hampered by disastrous technical failures afflicting a crucial federal website, Obama announced his nomination to succeed Sebelius, who he insisted had overseen reforms that will transform America.  Obama said Sebelius would “go down in history” as the health and human services secretary in post when the country “finally declared that quality affordable healthcare is not a privilege, but a right for every single citizen”. Sebelius, health secretary since Obama came to office in 2009, helped shepherd through the Affordable Care Act in 2010 and directed its subsequent implementation.  However, while crediting Sebelius with fostering such historic changes, Obama acknowledged the damage to the reputation of his administration caused by the website's failings. The glitches took months to repair, slowing the initial pace of enrolment for affordable healthcare coverage.  Obama said Sebelius had “helped guide [the law's] implementation, even when it got rough,” and added: “She’s got bumps. I’ve got bumps, bruises.”  He spoke in the Rose Garden, flanked by Sebelius and his new nominee for the role: Sylvia Mathews Burwell, the director of White House Office of Management and Budget, who he described as a competent manager who would oversee the remaining rollout of the laws which have come to be known as Obamacare.  With less than seven months to go before midterm elections, Democrats are keen to capitalise on strong enrolment figures reported as the sign-up period drew to a close. Hours before news of her departure leaked on Thursday, Sebelius announced that least 7.5 million Americans had enrolled for health coverage through the new exchanges, exceeding the administration’s targets.  The Affordable Care Act, a monumental piece of legislation designed to significantly expand healthcare coverage, is widely seen as Obama’s most significant domestic achievement. But it is also his most divisive. Republicans in the House of Representatives have passed more than 50 symbolic votes to repeal the ACA, which was also challenged unsuccessfully in the supreme court.  Republican strategists have already made Obamacare the focus of two elections, and are planning to make the failed rollout a central tenet of their campaign in November.  Obamacare overhauled the health insurance market, creating online healthcare exchanges and an individual mandate requiring almost all Americans to obtain coverage or pay a penalty.  In many states it also significantly expanded Medicaid, which provides healthcare to low-income Americans. Over the next decade, it is predicted that 25 million Americans will receive healthcare coverage as a result of the changes.  On Friday, Obama acknowledged that website failures had hampered the rollout of the healthcare exchanges, the central plank of the reforms, but he insisted the main problems had been overcome.  “Yes, we lost the first quarter of the open enrolment period with the problems with healthcare.gov – and there were problems," he said.  "But under Kathleen’s leadership, her team at HHS turned the corner, got it fixed, got the job done, and the final score speaks for itself: there are 7.5 million people across the country that have the security of health insurance, most of them for the very first time.”  The president described Burwell, a former president of the Bill and Melinda Gates Foundation, as “a proven manager" who “knows how to deliver results”.  Analysts said Burwell’s appointment was a shrewd move. As director of the OMB since April 2013, she has been directly involved in attempting to rescue the healthcare rollout but, unlike other possible nominees, has not until now been too closely associated with the law.  Her Senate confirmation for the OMB directorship passed with unanimous consent, making it difficult for Republicans to raise objections this time around. Burwell was also instrumental in facilitating the budget deal, which passed in December in a rare act of bipartisan co-operation.  John McCain was the first Republican senator to endorse Burwell, describing her as an “excellent choice”. The Senate minority leader, Mitch McConnell, was less enthusiastic, saying he hoped Burwell’s nomination was “the start of a candid conversation about Obamacare’s shortcomings”.  “It’s fitting that nearly one year after the primary legislative architect of Obamacare predicted it would be a train wreck, the government official most responsible for overseeing it reportedly is resigning,” he said.  “Regardless of the administration’s public explanation for the secretary’s exit, Obamacare has been a rolling disaster and her resignation is cold comfort to the millions of Americans who were deceived about what it would mean for them and their families.”  Even if right-leaning Republicans like Senator Ted Cruz wanted to stage a dramatic hold-up of Burwell's appointment, rules recently introduced by the Democratic majority leader, Harry Reid, make it much harder for senators to filibuster presidential nominations. Democrats, who control the Senate, will only need to muster 51 votes to ensure Burwell is confirmed.  Nonetheless, Burwell will not be able to escape what are likely to be intense grillings before congressional committees on Capitol Hill, where Republicans see an opportunity to remind voters of the stumbling rollout of the law.  Vulnerable Democratic senators in states such as Louisiana, Arkansas and North Carolina have already been hit by Republican attack ads focusing on healthcare. The ads often feature stories of people who lost their insurance plans – despite Obama’s famous promise that anyone who wanted to keep their plans could do so – or others who saw their premiums rise.  Some Democrats have been delicately distancing themselves from Obama, whose approval rating remains low, or going public with their own concerns over his healthcare reforms.  Sebelius’s slump began on 1 October 2013, the day the healthcare exchange website was launched – and promptly crashed. The problems initially received little attention, coinciding as it did with the the start of the government shutdown, which was orchestrated by Cruz and other rightwing Republicans in protest over Obamacare.  That move backfired, and it was not until the shutdown concluded two weeks later that the severity of the website's failings began to receive widespread attention.  Millions were unable to access the site, and at times it seemed the fiasco would undermine the entire healthcare law, which relies on sufficient numbers of young and healthy people signing up for new plans.  Hauled before Congress to explain the debacle, Sebelius, a former Democratic governor of Kansas, stumbled repeatedly. It was clear that her job was now not just to fix the website, but to absorb criticism and perhaps deflect attention from her boss.  "Hold me accountable for the debacle,” she told the House energy and commerce panel on 21 October. “I'm responsible.”  The White House eventually parachuted in a host of outside experts, including former Microsoft executive Kurt DelBene, to help fix the problems. Sebelius also took the executive decision to extend sign-up deadlines, and introduced other last-minute changes to keep Obamacare afloat – moves that were strongly criticised by Republicans.  But the fixes worked. After a slow start, enrolment picked up, with a dramatic rise in the number of people visiting the exchanges in the days and weeks leading up to the 31 March deadline.  By the time the enrolment period closed, on Monday last week, 7.1 million people had signed up. On Thursday, Sebelius used her final appearance before the Senate to announce a further 400,000 enrollees – a boost from the extended deadline – bringing the total to 7.5 million.  Republicans say that top-line figure is misleading, because the administration has not said how many of those who have already signed up for insurance closed the deal by paying their first month’s premiums. Neither have Sebelius or other senior officials said how many people lost their plans because they did not meet the requirements of the ACA.  However, Democrats clearly believe the winds have finally changed. Speaking at the White House on Friday, Sebelius described the health reforms as “the cause of my life”.  “I knew it wouldn’t be easy. There is a reason why no earlier president was successful in passing health reform, despite five decades of attempts,” she said.  “But throughout the legislative battles, the supreme court challenge, a contentious re-election and years of battles to turn back the clock, we are making progress. Tremendous progress.”  She added: “Critics and supporters alike are benefiting from this law.”
President praises outgoing health secretary in Rose Garden speech but Republican leader McConnell says Sebelius oversaw 'train wreck'