
Ms. Burwell, the White House budget director, was confirmed for that job 96-0 last April. But the bureaucratic sprawl of HHS deserves more than another congressional rubber stamp. Beyond the ObamaCare exchanges, the HHS Secretary controls a $1.01 trillion budget for fiscal 2015 with 79,540 employees that includes Medicare, Medicaid, the Food and Drug Administration, Head Start, the National Institutes and dozens of other programs.
Ms. Burwell is by all accounts a less inept administrator than Ms. Sebelius, even if this is another second-term promotion for a personal and ideological Obama loyalist. Like Treasury Secretary Jack Lew, Ms. Burwell is an acolyte of former Treasury Secretary Robert Rubin and close to the White House's Mr. Fix-it, John Podesta. HHS Secretaries usually have more independent stature.
A major reason that ObamaCare's prescriptive regulations and first six months have been such a rolling failure is that decision-making is centralized in the Oval Office. Most of the important choices were never Ms. Sebelius's. They were usually first resolved to the satisfaction of the political shop. Ms. Burwell has been part of this insular policy-making.
On that point, Senators cannot meaningfully exercise their advice and consent role without more information about the reality of ObamaCare's performance. The White House is enjoying a sugar high from the current bad-news lull, but HHS's credibility has become a running joke among all but the most reliable partisans.
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