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Sebelius Confirmation Delayed by GOP Objection, Baucus Says

By John Reichard, CQ Staff

April 2, 2009 -- Senate confirmation of Kansas Gov. Kathleen Sebelius to head the Department of Health and Human Services probably won't take place until after the coming two-week recess because at least one senator has objected to an expedited procedure to move the nomination.

"I'm afraid there's a senator who will not grant consent so that means it has to be delayed until after the recess," Finance Chairman Max Baucus, D-Mont., said Thursday.

Baucus would not name the senator other than to say he or she is a Republican.

Earlier, at Sebelius' confirmation hearing with his committee, Baucus had predicted the Senate would confirm the nominee Thursday.

Baucus indicated that the nomination would not be held up by Sebelius' disclosure that she and her husband paid almost $8,000 in back taxes and interest owed because of filing errors.

The tax issue, revealed March 31, prompted no questions during the hearing.

Sebelius will play a central role in President Obama's effort to overhaul the health care system.

The Department of Health and Human Services (HHS) oversees programs such as Medicare and Medicaid, the Food and Drug Administration, the National Institutes of Health, and other public health and welfare agencies responsible for nearly $80 billion in annual discretionary spending and hundreds of billions more through entitlement programs.

The Obama administration appears to have dodged a Senate battle over abortion that might have come with Sebelius' nomination. The governor has clashed several times with the Kansas Legislature over her support of abortion rights, but the state's two conservative Republican senators, Sam Brownback and Pat Roberts—both prominent opponents of abortion—have lent her their support.

Thursday's hearing featured a bipartisan goodwill for the nominee and a sense of urgency that a health overhaul is essential this year.

Deep partisan divisions appeared, however, when the hearing focused on whether Congress should create a government-run health insurance program alongside private plan options.

Even moderate Republican Olympia Snowe of Maine expressed skepticism about a public program, saying it should be a "last resort." Sebelius, however, offered a firm defense, citing as successful models programs in many states offering state employees a menu of health insurance plans.

Panel members also showed the divide over whether to use budget reconciliation procedures to move a health overhaul bill. The fast-track tactic would allow Democrats to forestall potential Republican filibusters in the Senate.

Michael B. Enzi, R-Wyo., gently counseled Sebelius to refrain from advocating for the procedure, saying that a successful health overhaul will require bipartisan work to resolve many knotty issues.

The House budget resolution (H Con Res 85), which is expected to be adopted Thursday by the House, includes language that would allow legislation overhauling health care to move via reconciliation later in the year. The Senate measure (S Con Res 13), which is working toward adoption Thursday night or Friday morning, does not include such direction.

Enzi said that he, Roberts and Orrin B. Hatch, R-Utah, "have a great responsibility to keep Republicans calm through the debate."

The hearing was almost devoid of surprises. When asked by Baucus, however, whether anything in her background might create a conflict of interest, Sebelius mentioned that an HHS ethics officer had noted two stocks in her husband's portfolio. Sebelius said her spouse is committed to divesting them.

Details weren't immediately available on the stocks involved or their value.

Sebelius did break some new ground in her comments by saying that she thinks a health overhaul should fill the coverage gap in Medicare prescription drug known as the "doughnut hole."

Congressional Democrats have shied away from talk of filling the gap because of the tens of billions of dollars in expense involved.

On another issue that may raise Republican hackles, Sebelius said she would welcome legislation giving the HHS secretary authority to negotiate the prices of prescription drugs covered by the Medicare program.

"I would look forward to managing that aggressively," Sebelius said in response to a question by Sen. Bill Nelson, D-Fla. Medicare "overpays" for prescription drugs covered by the program's Part D drug benefit, she said.

Drama Ending
Sebelius' confirmation would help bring to a close a painful transition period for the White House in which reporters stopped referring to the president as "No Drama Obama" to describe his administrative skills in favor of a story line emphasizing inept vetting. The nominations of a half-dozen appointees were clouded by reported tax problems, with that of former Senate Majority Leader Tom Daschle (1987–2005) by far causing the administration the greatest embarrassment.

The $7,040 in back taxes and $878 in interest Sebelius said she and her husband paid to correct filing errors pales in comparison to the $140,000 in back taxes paid by Daschle and are viewed by lawmakers as minor errors. Daschle's withdrawal also occurred after reports that he received tens of thousands of dollars in speaking fees from insurers in the period after he left the Senate.

Those fees raised some concern that Daschle might be too close to industry heading into the health overhaul debate.

Sebelius, on the other hand, won a reputation for taking a firm hand with insurers when, as Kansas insurance commissioner before becoming the state's governor in 2002, she blocked the purchase of Blue Cross and Blue Shield of Kansas by the big Indiana-based insurer Anthem.

"Governor Sebelius has a proven ability to make tough decisions in the face of fierce opposition," Finance Committee Democrat Sen. John Rockefeller, IV, D-W.Va., said in a statement released at the hearing.

Sebelius said she acted because of evidence that premiums in the state "would have increased too much."

But Sebelius lacks Daschle's close ties to members of Congress that could have aided negotiations on a health overhaul. And her late arrival on the job complicates the challenges the Obama administration faces of achieving a health overhaul this year, one of its top priorities.

Both Presidents Bill Clinton and George W. Bush got their HHS nominations through the Senate considerably faster when they first came to town. Clinton's appointee, Donna E. Shalala, was confirmed on January 22, 1993, while Bush's appointee, Tommy G. Thompson, was confirmed February 2, 2001.

But despite the late start, Obama is far ahead of the Clinton White House in getting congressional committees started on a health overhaul. Committees in the Clinton era cooled their heels until late in 1993 awaiting his elaborate overhaul proposal; Obama is letting Congress fill out the details, a process that is already well underway despite the many difficulties it faces resolving differences over financing and the design of a program to expand coverage.

Drew Armstrong and David Clarke contributed to this story.

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