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 Burwell, Obama's widely respected budget director, discussed the
Patient Protection and Affordable Care Act in terms that sometimes
seemed calculated to appeal to Republicans. At one point she defined
healthcare "affordability" in terms of its cost to taxpayers and the
economy, as well as the law's intended beneficiaries, many of them
low-income Americans.
"We don't always agree. But if we can have conversations and those
conversations can be specific, I think we can work to figure most
things out," she told the Senate Finance Committee that will decide
whether to send her nomination on for a final vote in the Senate.
Republicans have made Obamacare their leading campaign issue in
November's election battle for control of the Senate. Analysts and
congressional aides say Burwell's immediate task, if she is
confirmed as secretary of health and human services, will be to
prevent problems with the law that could reverberate on the campaign
trail.
Burwell, who received a cordial reception at her first hearing
before a different Senate panel last week, got another bipartisan
introduction from her home state Democratic Senator Jay Rockefeller
of West Virginia and Senator Tom Coburn of Oklahoma, a prominent
Republican voice on healthcare issues who praised her competence and
character.
"My favorite quote is: 'There's a-thimble-and-a-half-full of common
sense in Washington.' And she's the half," Coburn said.
Republicans again expressed concerns about what they see as the 2010
law's shortcomings: reduced Medicare payments for insurers,
insurance policy cancellations, the inability of some enrollees to
keep their doctors and an uneven implementation schedule that has
delayed penalties for employers but kept them in place for
individuals who fail to obtain healthcare.
"We can be very cordial today. But if you want to change the
relationship your department has with Congress, you're going to have
to be willing to break the by-any-means-necessary mindset that we
have seen for the past five years," said Senator Charles Grassley,
an Iowa Republican.
Some analysts say the muted Republican questioning at the two
hearings stems from party divisions on how to proceed with
opposition to Obamacare, which up to now has focused largely on
repealing the law.
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"The GOP isn't backing off. But once you get past the public's
overall opposition to ACA, their views are nuanced: they want it
fixed. And Republicans are struggling mightily on the ground to come
up with a fix," said Bill Pierce, a healthcare official under former
President George W. Bush.
Another reason for the conciliatory Republican tone appears to be
Burwell herself. She has met privately with individual senators,
Republican and Democratic, and those meetings have led to praise
from lawmakers of both parties.
On Wednesday, lawmakers appeared to accept Burwell's reassurances
that she would pursue a transparent, common-sense approach to health
reform implementation and place a high priority on responding to
their questions.
"You're going to need all the luck you can get," said Senator Orrin
Hatch of Utah, the committee's senior Republican. "But I'm grateful
for people willing to take on these tough responsibilities and lend
their best expertise to it. I'm grateful that you are willing to
serve," he said.
Finance Committee Chairman Ron Wyden, an Oregon Democrat, said the
panel would move quickly on deciding whether to forward Burwell's
nomination to the Senate floor.
(Additional reporting by David Lawder; Editing by Caren Bohan,
Bernard Orr and Mohammad Zargham)
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