Who is Sylvia Mathews Burwell? The likely new face of Obamacare.

Health secretary nominee Sylvia Mathews Burwell, from small-town West Virginia, has served in numerous government posts, including Obama's budget director. Republicans praise her low-key manner.

President Barack Obama, stands with his nominee to become Health and Human Services secretary, Budget Director Sylvia Mathews Burwell, while speaking in the Rose Garden of the White House in Washington, Friday, April 11, 2014, where he made the announcement. Burwell would replace Kathleen Sebelius who announced her resignation Thursday.

Susan Walsh/AP

April 11, 2014

If President Obama gets his wish, Sylvia Mathews Burwell will be his new Health and Human Services (HHS) secretary – and the new face of Obamacare.

Ms. Burwell, nominated Friday by Mr. Obama to replace the embattled Kathleen Sebelius at HHS, is no stranger to that turbulent place where policy meets politics. As Obama’s budget director for almost a year, Burwell had to manage the first partial federal government shutdown in 17 years last October. And she helped lead negotiations last summer with Senate Republicans on a possible “grand bargain” to raise taxes and reform entitlements.

Those talks failed, but Republicans praised her low-key manner and genial demeanor, a style that will serve her well if she is confirmed, as expected, to run HHS. The turbulent first open enrollment period for Healthcare.gov has finished, and now Secretary Sebelius is ready to hand off the heavy lifting of continuing Obamacare implementation, running a massive government department with numerous agencies, and facing off against Republicans on Capitoll Hill.

In his announcement in the White House Rose Garden Friday, Obama offered praise for Sebelius, and spoke highly of Burwell’s leadership ability.

Burwell is “a proven manager who's demonstrated her ability to field great teams, forge strong relationships, and deliver excellent results at the highest levels, and she's done it both in the public and private sector,” Obama said.

The president also noted her small-town roots – she grew up in Hinton, W.V. – and praised her “common sense.”

“She brings the values of caring about your neighbor and ordinary folks to some of the biggest and most complex challenges of her time," Obama said.

The daughter of a doctor and small-town mayor, and the granddaughter of Greek immigrants, Burwell has worked in and out of government much of her adult life. She served in a succession of posts during the Clinton administration: staff director for the National Economic Council, chief of staff to the Treasury secretary, deputy chief of staff for policy to President Clinton, and finally, deputy director of the Office of Management and Budget, which she currently runs.

Can Syria heal? For many, Step 1 is learning the difficult truth.

In the private sector, she worked for the Bill & Melinda Gates Foundation, and more recently led the Walmart Foundation. Before joining the Clinton administration, she worked for McKinsey & Company consultancy.

Burwell also has political experience. Her mother was mayor of Hinton, and while in college, Burwell interned for Rep. Nick Rahall (D) of West Virginia. Later, she worked for the Dukakis and Clinton presidential campaigns.

Burwell received her undergraduate degree from Harvard University, and got another degree from Oxford University as a Rhodes scholar.

In person, Burwell comes across as down-to-earth. As the guest at a breakfast last month hosted by The Christian Science Monitor, she expressed concern for the welfare of federal workers, who have dealt with furloughs and frozen pay in recent years. As head of OMB, she said, maintaining and developing a high-quality federal workforce would be one of her top priorities.

“It’s a very challenging issue,” Burwell said at the breakfast. “I can’t tell you the point in time when we crash. It’s important enough we need to bear down.”

She also described the decisionmaking process she went through when she was offered the OMB directorship, and considered what it would mean for her husband, lawyer Steve Burwell, and their two young children to move from Bentonville, Ark., to Washington, D.C.

“I sat there with the yellow pad and [was] like, OK, what are the pros and cons, what will be the things that will be difficult, let me think through this before we make a decision as a family,” said Burwell.

On Facebook, Democratic strategist Peter Fenn, who lives near the Burwells, described them as “terrific neighbors.”

“Sylvia will do a wonderful job as the new head of HHS,” Mr. Fenn said. “She is solid, savvy, and smart, and can deal with Congress.”

Burwell also earned early praise from the other side of the aisle. Sen. John McCain (R) of Arizona tweeted Thursday night that Burwell was “an excellent choice to be the next HHS secretary.”

Other Republicans withheld judgment on Burwell’s nomination, but spared no words on the Affordable Care Act.

“The president’s signature domestic policy achievement is an unmitigated disaster,” Sen. Orrin Hatch (R) of Utah, ranking member of the Senate Finance Committee, said Friday in a statement. “This deeply flawed law has hurt millions of hard-working American families, job creators, and seniors in the form of rising premiums, higher taxes, and fewer choices.”

Still, Senator Hatch said he looked forward to a “frank discussion” on her nomination and would work with his committee colleagues toward a “fair and thorough vetting process.”

Another key Senate Republican was less charitable.

“I am concerned that director Burwell may have been chosen because the president believed her to be another political loyalist who would toe the party line,” said Sen. Jeff Sessions (R) of Alabama, ranking member of the Senate Budget Committee, in a statement.

“Ms. Burwell has a comparatively thin resume for the demands now placed on this position – she has never run anything on the scale of HHS – and, during her short stint as budget director, she did more to obscure the nation’s poor financial state than to illuminate it.”