Sylvia Burwell testified on Thursday before the Senate Health, Education, Labor, and Pensions (HELP) Committee in her first appearance towards confirmation as the administration’s new Secretary of Health and Human Services.
"If I am confirmed, I will implement the law and the law is a system that is a market based system, and that’s what the exchanges are up and running and putting people in systems that are private insurance systems. I look forward to, if confirmed, making that system work as efficiently and effectively as possible both in terms of cost and access," Burwell told the committee.
Burwell’s comments came in response to a question from Sen. Pat Roberts (R., Ks.) asking if she agreed with statements by Senate Majority Leader Harry Reid that the "goal was to move the Affordable Healthcare Act to a single payer system."
"There is a difference between administering a law and pushing an agenda," Roberts noted.
Burwell was expected to face "tough" questioning from Republicans, but the hearing ended without any contentious exchanges. Most lawmakers seemed to praise Burwell.
Sens. John McCain (R., Ariz.) and Joe Manchin (D., W.V.) appeared on her behalf as witnesses, offering opening statements of acclaim and calling her a "friend."
Sen. Richard Burr (R., N.C.) announced that while the HELP Committee would not vote on her confirmation, the Finance Committee would and in his position there he would vote to confirm her.
Some Republicans, such as Roberts, pressed her on the Affordable Care Act and her position on the law long term.
"Obamacare has been delayed at least thirty-five times. Twenty-two of those times were done unilaterally by the administration. Since being the director of OMB [Office of Management and Budget], you have approved fifteen of these twenty-two delays. This included the second delay of the employer mandate," Roberts said.
Burwell maintained that the changes carried out to date were a part of a necessary "transition" period.
"Senator, I think the changes that you’re referring to are a number of different things that have been taken by different departments—Treasury or HHS … With regard to what is happening as this process goes forward, from the administration’s perspective, what we are trying to do is common sense implementation within the law."
One of the most notable delays occurred following the outrage over canceled insurance plans.
The administration provided an option for companies and states to decide whether they would continue offering those plans. Initially the extension was for a year and then for up to three years.
Burwell would not say if she would support extending that delay beyond the current three years.
"Right now the changes that have been put in place are changes that a part of a transition period as people are transitioning to a point where we can implement a system, and that’s a system where preexisting conditions are covered, where women and gender issues can’t be discriminated against," she said.
Sen. Roberts interrupted, "Well now, is that a no or a yes? Or are you just not prepared to say at this point?"
"Senator, at this point I think we want to see what is happening in regards to the issues of implementation."
Burwell is currently the Director of the Office of Management and Budget (OMB), a position she was confirmed in with unanimous consent.
The next confirmation hearing will be before the Senate Finance Committee. That committee will decide whether or not to send Burwell’s nomination to the Senate floor for the final confirmation vote.