Senate unlikely to vote on Gov. Sebelius' nomination as HHS Secretary until later this month

Kansas Gov. Kathleen Sebelius (D), President Obama's choice for HHS secretary, "sailed through" a Senate Finance Committee confirmation hearing on Thursday, but the Senate likely will not take up the nomination until later this month because of objections for an immediate vote by several Republican members, the New York Times reports (Pear, New York Times, 4/3).

According to the Washington Times, committee members "peppered" Sebelius "with nuts-and-bolts queries about how she would oversee" HHS and her views on health reform proposals (Lengell, Washington Times, 4/3). In response to a question from committee Chair Max Baucus (D-Mont.) on whether she supported expanding coverage to all U.S. residents, Sebelius said that she and Obama both believed everyone should be insured. Sebelius avoided a secondary question from Baucus on legally requiring all people to get insurance, the AP/Houston Chronicle reports. Sebelius said, "There may be variations about how best to reach the goal most effectively, most cost-effectively, most efficiently, with the best health outcomes of insuring every American," adding, "I think [Obama is] open to all of those proposals" (Alonso-Zaldivar/Werner, AP/Houston Chronicle, 4/2).

Sebelius also said that she supports a public insurance option that is "constructed effectively and wisely" and includes "actuarial support." The issue of whether health reform legislation would include a public option already has "emerged as [a] key stumbling block" in negotiations between Democrats and Republicans, according to the Wall Street Journal. Congressional Democrats typically favor a public option, while Republicans "readily dismiss the concept." According to the Journal, it is not clear whether a bipartisan compromise could be reached on the issue. Sebelius responded to questions about a public coverage option by noting that a Kansas state employee health plan that is run by the government and the California Medicaid public plan both help to create competition in a market where little exists (Yoest, Wall Street Journal, 4/2). She said, "Often when you have 60% to 70% of market share, you have a monopoly, and it's really not a competitive environment. We have examples throughout the country of very competitive, very effective strategies." She also told the panel that warnings issued by Republican lawmakers that a national public insurance plan would have negative effects on the health insurance market were not accurate. "It has not destroyed the market, it has not tilted the playing field. It is all the way the structure is set," Sebelius said (Wall Street Journal, 4/2).

When asked if she supported passing health care overhaul legislation through the budget reconciliation process, which requires 51 votes to avoid filibuster as opposed to the typical 60, Sebelius said that she favors a bipartisan solution but that she would want to keep all options under consideration (AP/Houston Chronicle, 4/3). The New York Times reports that panel members did not question Sebelius about her position or record on abortion or about her recent disclosure that she had repaid about $7,000 in back taxes resulting from accounting errors (New York Times, 4/3).

Sebelius added that she believes that U.S. residents have a personal responsibility to stay healthy and that, if confirmed, she would emphasize preventive medicine. "We cannot achieve our ultimate goal -- a healthier nation -- unless we shift away from a sick-care system," she said, adding, "We pay for emergencies, not the care that prevents them" (Washington Times, 4/3).

Confirmation Vote

The panel can move for a full Senate confirmation vote without the required 48 hours' notices only with the unanimous consent of the Senate (Armstrong/Reichard, CQ Today, 4/2). However, Sebelius likely will not be confirmed as HHS secretary until after the two-week congressional recess that begins Monday because some Republicans objected to holding the vote the same day as the hearing, The Hill reports (Young, The Hill, 4/2).

Both Republican and Democratic senators submitted "dozens of written questions" to Sebelius and the lawmakers wanted to wait to review her answers before the confirmation vote (New York Times, 4/3). A Republican aide said, "We want to have answers, and we want to have time to consider them," adding, "That's not uncommon" (Brady, Roll Call, 4/2). Baucus "signaled some frustration" at the delay, according to CQ Today. "The administration needs its people in place," he said, adding, "I wish we could get her confirmed today" (CQ Today, 4/2).

Daschle, Other Senators To Submit Proposal

Former Senate Majority Leader Tom Daschle (D-S.D.) and former Sens. Bob Dole (R-Kan.), Howard Baker (R-Tenn.) and George Mitchell (D-Maine), the founders of the Bipartisan Policy Center, are expected to present to lawmakers several ideas on health reform by May, Politico reports. Dole this week told two Senate committees that the proposal is being prepared. Chris Jennings and Mark McClellan, who worked on health policy in the Clinton and George W. Bush administrations, respectively, are assisting the group (Budoff Brown, Politico, 4/2).