Health secretary confirmed

WASHINGTON – New management, same problems. Sylvia Mathews Burwell was confirmed Thursday as the nation’s new health secretary, but she’ll have to act quickly to head off more insurance chaos this fall.

The 78-17 Senate vote was a bipartisan show of support for the veteran government manager who most recently served as President Barack Obama’s budget director.

Burwell’s attention will immediately turn to the Health and Human Services Department’s newest mission: covering the uninsured under Obama’s health care law. Despite a strong finish to open enrollment this year, HealthCare.gov is still dealing with unresolved issues ranging from possibly inaccurate insurance payments to e-commerce basics.

The White House desperately wants to avoid more attention-grabbing problems when sign-up season starts Nov. 15. Democrats expressed the hope that Burwell’s confirmation might usher in a fresh start for “Obamacare,” but Republicans indicated they wouldn’t play along. Health experts pointed to difficulties ahead.

“There is the potential for a huge mess again,” said Robert Laszewski, a health care industry consultant.

HHS will be responsible for insuring people in more states this fall, after several states flopped at running their own insurance exchanges. But Republicans in Congress are unsympathetic to the administration’s request for $600 million for the enrollment effort, on top of $1.2 billion to be raised from user fees paid by insurers.

Additionally, lawmakers are concerned that many consumers could have gotten the wrong subsidy this year for coverage under Obama’s law.

An HHS document shows that at least 2.1 million people have paperwork “inconsistencies” that could affect their eligibility or the size of their subsidy. If widespread problems surface, it could be a major new issue for the law’s opponents. It could turn into a financial headache for some consumers, since their tax refunds could be trimmed if they got too big a health care subsidy.