General Articles

New HHS Secretary Nominated; Lack of HHS Secretary Has Created a “Leadership Void”

According to The Hill, the lack of a nominee for Secretary of the U.S. Department of Health and Human Services (HHS) has created a “leadership void” at the department that could “delay the Obama administration from putting its stamp on the massive bureaucracy.” Although day-to-day operations continue at HHS, the lack of a secretary and leaders at key agencies within HHS is resulting in a department void of the ability to create new policies and enact the President’s new health priorities. The current senior leadership—which includes some former employees of the Bush administration and a small number of appointees by President Obama—“lack the clout to set new policy” or “make big changes to departmental policy without explicit direction from the highest levels of the administration,” says The Hill. Charles Johnson, a Bush appointee as assistant secretary for budget, is acting-HHS secretary.[i]
President Obama recently nominated Kansas Governor Kathleen Sebelius (D), after his first nominee for the position withdrew. Governor Sebelius accepted the nomination and, if confirmed, will be “stepping into a central role in the new administration’s ambitious effort to overhaul the nation’s health-care system,” according to the Washington Post.[ii] Sebelius is halfway through her second term as Kansas’ Governor. She previously served as state insurance commissioner for eight years and has overseen the state’s Medicaid program. During her tenure as Governor, even though Sebelius unsuccessfully attempted to expand health coverage in the state through higher cigarette taxes, Kansas has still added tens of thousands of low-income children to state health programs.[iii]
According to the Washington Post, Governor Sebelius is known “for reaching across the aisle in her Republican-dominated state.”[iv] That said, Governor Sebelius, a Roman Catholic who supports abortion rights, has “endured fierce and often personal criticism” from abortion-rights opponents who have “promise[d] a vigorous fight” against her nomination. Abortion opponents acknowledged that they would “probably be uncomfortable with nearly anyone Obama nominates, but they’re particularly upset by the prospect of Sebelius.”[v]
If confirmed by the Senate, Governor Sebelius would occupy the Cabinet position originally slated for Former Senator Daschle (D-SD) who withdrew from consideration the first week in February. His withdrawal was precipitated by continued controversy related to tax issues, according to the New York Times.[vi] Mr. Daschle told President Obama that he believed he had become a distraction to the administration and would be unable to lead an overhaul of the nation’s health care system “with the full faith of the Congress and the American people,” according to a statement the White House distributed after the announcement. “I am not that leader,” Mr. Daschle said, “and will not be a distraction.”[vii] The controversy prompted Obama to acknowledge that he had “screwed up.”[viii]
The White House admitted that it did not have an immediate second choice for HHS secretary after Mr. Daschle, which has meant that HHS has been without a secretary in place for much longer than is typical for a new administration. According to The Hill, tradition dictates that a President does not normally nominate people for jobs such as FDA commissioner, Centers for Disease Control and Prevention (CDC) director, Centers for Medicare and Medicaid Services (CMS) administrator, or Nationals Institutes of Health (NIH) director until an HHS secretary is nominated and confirmed. According to former Wisconsin Governor Tommy Thompson (R), who was HHS secretary during President George W. Bush’s first term, “There’s always the secretary appointed first.” Thompson emphasized that, while the department is capable of carrying out its basic responsibilities without a secretary or agency heads in place for a time, leadership at the top matters, starting with the secretary’s role advising the president on whom to choose to fill the upper echelons of the department’s staff and to lead its larger agencies.[ix]

[i] Jeffrey Young, “HHS idles as top jobs go unfilled,” The Hill, 12 February 2009, accessed 16 February 2009,

[ii] Michael A. Fletcher and Ceci Connolly, “Governor of Kansas Tapped to Lead HHS,” Washington Post, 2 March 2009, accessed 2 March 2009,

[iii] Ibid.

[iv] Ibid.

[v] John Hannah, “Abortion foes vow to fight a Sebelius nomination,” Associated Press, 27 February 2009, accessed 2 March 2009, <>.

[vi] Jeff Zeleny, “Daschle Ends Bid for Post; Obama Concedes Mistake,New York Times, 3 February 2009, accessed 16 February 2009,

[vii] Ibid.

[viii] Fletcher and Connolly. “Governor of Kansas Tapped to Lead HHS.”

[ix] Young, “HHS idles as top jobs go unfilled.”