S. HRG. 111–804 NOMINATION OF GOVERNOR KATHLEEN SEBELIUS HEARING OF THE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS UNITED STATES SENATE ONE HUNDRED ELEVENTH CONGRESS FIRST SESSION ON NOMINATION OF GOVERNOR KATHLEEN SEBELIUS, OF KANSAS, TO BE SECRETARY, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES MARCH 31, 2009 Printed for the use of the Committee on Health, Education, Labor, and Pensions ( Available via the World Wide Web: http://www.gpo.gov/fdsys/ U.S. GOVERNMENT PRINTING OFFICE 48–540 PDF WASHINGTON : 2010 For sale by the Superintendent of Documents, U.S. Government Printing Office, http://bookstore.gpo.gov. For more information, contact the GPO Customer Contact Center, U.S. Government Printing Office. Phone 202–512–1800, or 866–512–1800 (toll-free). E-mail, [email protected]. VerDate Nov 24 2008 15:54 Jan 20, 2011 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 S:\DOCS\48540.TXT DENISE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS EDWARD M. KENNEDY, Massachusetts, Chairman CHRISTOPHER J. DODD, Connecticut MICHAEL B. ENZI, Wyoming TOM HARKIN, Iowa JUDD GREGG, New Hampshire BARBARA A. MIKULSKI, Maryland LAMAR ALEXANDER, Tennessee JEFF BINGAMAN, New Mexico RICHARD BURR, North Carolina PATTY MURRAY, Washington JOHNNY ISAKSON, Georgia JACK REED, Rhode Island JOHN MCCAIN, Arizona BERNARD SANDERS (I), Vermont ORRIN G. HATCH, Utah SHERROD BROWN, Ohio LISA MURKOWSKI, Alaska ROBERT P. CASEY, JR., Pennsylvania TOM COBURN, M.D., Oklahoma KAY R. HAGAN, North Carolina PAT ROBERTS, Kansas JEFF MERKLEY, Oregon J. MICHAEL MYERS, Staff Director and Chief Counsel FRANK MACCHIAROLA, Republican Staff Director and Chief Counsel (II) VerDate Nov 24 2008 15:54 Jan 20, 2011 Jkt 000000 PO 00000 Frm 00002 Fmt 0486 Sfmt 0486 S:\DOCS\48540.TXT DENISE CONTENTS STATEMENTS TUESDAY, MARCH 31, 2009 Page Kennedy, Hon. Edward M., Chairman, Committee on Health, Education, Labor, and Pensions, opening statement ........................................................... 1 Enzi, Hon. Michael B., a U.S. Senator from the State of Wyoming, opening statement .............................................................................................................. 2 Prepared statement .......................................................................................... 3 Roberts, Hon. Pat, a U.S. Senator from the State of Kansas .............................. 5 Prepared statement .......................................................................................... 6 Baker, Hon. Nancy Kassebaum, a U.S. Senator from the State of Kansas, prepared statement .............................................................................................. 7 Dole, Hon. Robert J., Former U.S. Senator from the State of Kansas ................ 7 Prepared statement .......................................................................................... 10 Brown, Hon. Sherrod, a U.S. Senator from the State of Ohio ............................. 12 Sebelius, Kathleen, Governor, State of Kansas, Topeka, KS ............................... 13 Prepared statement .......................................................................................... 16 Mikulski, Hon. Barbara A., a U.S. Senator from the State of Maryland ............ 23 Isakson, Hon. Johnny, a U.S. Senator from the State of Georgia ....................... 25 Harkin, Hon. Tom, a U.S. Senator from the State of Iowa .................................. 27 McCain, Hon. John, a U.S. Senator from the State of Arizona ........................... 29 Murray, Hon. Patty, a U.S. Senator from the State of Washington ................... 30 Coburn, Hon. Tom, a U.S. Senator from the State of Oklahoma ........................ 32 Dodd, Hon. Christopher J., a U.S. Senator from the State of Connecticut ......... 34 Prepared statement .......................................................................................... 35 Murkowski, Hon. Lisa, a U.S. Senator from the State of Alaska ........................ 39 Reed, Hon. Jack, a U.S. Senator from the State of Rhode Island ....................... 41 Burr, Hon. Richard, a U.S. Senator from the State of North Carolina ............... 42 Sanders, Hon. Bernard, a U.S. Senator from the State of Vermont ................... 44 Casey, Hon. Robert P., Jr., a U.S. Senator from the State of Pennsylvania ...... 48 ADDITIONAL MATERIAL Response by Kathleen Sebelius to questions of: Senator Kennedy .............................................................................................. 53 Senator Harkin ................................................................................................. 54 Senator Mikulski .............................................................................................. 56 Senator Murray ................................................................................................ 57 Senator Reed ..................................................................................................... 60 Senator Brown .................................................................................................. 61 Senator Casey ................................................................................................... 62 Senator Hagan .................................................................................................. 63 Senator Enzi ..................................................................................................... 64 Senator Hatch ................................................................................................... 75 Senator McCain ................................................................................................ 81 Senator Murkowski .......................................................................................... 87 Senator Coburn ................................................................................................. 90 Senator Burr ..................................................................................................... 92 Senator Alexander ............................................................................................ 95 (III) VerDate Nov 24 2008 15:54 Jan 20, 2011 Jkt 000000 PO 00000 Frm 00003 Fmt 0486 Sfmt 0486 S:\DOCS\48540.TXT DENISE VerDate Nov 24 2008 15:54 Jan 20, 2011 Jkt 000000 PO 00000 Frm 00004 Fmt 0486 Sfmt 0486 S:\DOCS\48540.TXT DENISE NOMINATION OF GOVERNOR KATHLEEN SEBELIUS TUESDAY, MARCH 31, 2009 U.S. SENATE, COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS, Washington, DC. The committee met, pursuant to notice, at 10 a.m. in Room SH– 216, Hart Senate Office Building, Hon. Edward M. Kennedy, Chair- man of the committee, presiding. Present: Senators Kennedy, Dodd, Harkin, Mikulski, Murray, Reed, Sanders, Brown, Casey, Enzi, Burr, Isakson, McCain, Mur- kowski, Coburn, and Roberts. OPENING STATEMENT OF SENATOR KENNEDY The CHAIRMAN. We will come to order. We are expecting Senator Enzi to be here in just a moment or two, but he has asked us to go ahead, and we shall. Our hearing today is on the confirmation of Kathleen Sebelius to serve as the next Secretary of Health. Few debates in Congress touch our lives as profoundly and per- sonally as healthcare. Over the past 10 months, I have seen our healthcare system up close. I have benefited from the best of medi- cine. But we have too many uninsured Americans. We have sickness care and not healthcare. We have too much bureaucracy—paper- work and bureaucracy. Costs are out of control. Today, we have an opportunity like never before to reform our healthcare, and we need a Secretary of Health who has the vision, the skill, and the knowledge to help us get there. Governor Kath- leen Sebelius has those traits and more. She was named one of the five top Governors by Time magazine. She earned that accolade by reaching across the aisle to find solutions that worked. Her Healthy Kansas initiative put thousands of people on the road to better health. As insurance commissioner and as Governor, she has been a strong voice for the rights of patients and con- sumers. When it comes to reforming our healthcare system, we know that challenges are great. I have the confidence that Governor Sebelius can lead the way with common sense solutions. Although her du- ties as Secretary may begin with healthcare reform, they do not end there. Food safety, drug safety, medical research, disease pre- vention—all of these and more have urgent need for attention. She (1) VerDate Nov 24 2008 15:54 Jan 20, 2011 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 S:\DOCS\48540.TXT DENISE 2 is the right person for the job, and I strongly support her nomina- tion. Governor, we welcome you today and thank you for your willing- ness to help serve in this important position. I know Senator Enzi will be here in just a moment or two. I will ask that we move ahead then with—ah, there we are. Senator ENZI. I went to the wrong room. The CHAIRMAN. Good to see you. We have got two arrivals here, two arrivals. We are doubly blessed this morning. So we will move ahead with our friend and colleague and leader, Senator Enzi. We thank you very much for being here. STATEMENT OF SENATOR ENZI Senator ENZI. Thank you, Mr. Chairman. It is always good to have you back, and it’s a great day for a hearing. I would like to begin by thanking you for holding this hearing today, and I have previously said confirming the President’s nomi- nees is one of the most important constitutional duties of the Sen- ate. I know that the members of the committee take the ‘‘Advise and Consent’’ clause of the Constitution