ADVERTISEMENT

WASHINGTON – Everyone knew it was a disaster. After Kathleen Sebelius appeared on “The Daily Show with Jon Stewart” in October, she and her staff at the Department of Health and Human Services felt she had been sandbagged by Stewart. At the White House, President Obama’s top aides were aghast at her wooden performance.

The White House frustration with Sebelius crystallized by Thanksgiving, as it became clear in Washington that she would eventually have to go. Republicans were brutalizing her at congressional hearings. The health care website’s problems were consuming the White House. Under mounting pressure from congressional Democrats panicking about the fallout from the health care debacle on their fall campaigns, Obama had brought in Jeffrey D. Zients, a management guru, to take control of the crisis from Sebelius.

In the halls of the Hubert H. Humphrey Building, the hulking structure at the foot of Capitol Hill that houses the sprawling social services agency, it was obvious to members of Sebelius’ staff that the president’s inner circle was losing confidence in her, several said Friday as the president announced his intention to replace Sebelius with Sylvia Mathews Burwell, his budget chief.

But three things put off Sebelius’ departure: Obama’s fear that letting people go in the middle of a crisis would delay fixing the website; his belief that ceremonial firings are public concessions to his enemies; and the admiration and personal loyalty that Obama still felt for Sebelius and her advocacy for his chief domestic legacy.

Over the next four months, Sebelius engaged in a kind of slow-motion resignation, largely staying out of the national limelight but crisscrossing the country in a furious effort to enroll people in health insurance and taking comfort from strangers who recognized – and offered thanks – for her efforts.

As the website improved and enrollment numbers neared the administration’s goal of 7 million people, she began plotting her exit.

“My balance has always been, ‘When? How do you make that decision?’ I have had conversations off and on with the president about that very thing,” Sebelius said in an interview Thursday. “It became more definite in early March, when I felt confident that we were well on our way to a robust enrollment.”

By then, the conversations between Sebelius and the president about her future had evolved, she said. In the self-sacrificial and expected conduct of high-level officials under siege in Washington, Sebelius offered to resign during a series of conversations with Obama.

And in the way that often happens in Washington, Obama did not protest.

The result was an orchestrated going-away ceremony Friday morning that capitalized on the enrollment success and sought to artfully minimize the political damage wrought by the law. Sebelius entered the Rose Garden by Obama’s side and received an extended standing ovation from White House and Department of Health and Human Services staff members seated on the lawn.

“Yes, we lost the first quarter of open enrollment period with the problems with HealthCare.gov – and they were problems,” Obama conceded. “But under Kathleen’s leadership, her team at HHS turned the corner, got it fixed, got the job done, and the final score speaks for itself: There are 7.5 million people across the country that have the security of health insurance, most of them for the very first time.”

White House officials – who in private have often complained about Sebelius’ management failings and lack of political antennas – emphasized the positive Friday, saying that no one had done more to make the long-sought hope of a national health care overhaul a reality.

In the interview Thursday, Sebelius recalled the dark moments after the appearance on Stewart’s show, when she and her staff were “feeling a little glum about that particular encounter.”

At the Hilton hotel lobby in New York where she was staying, a man approached after recognizing her. His daughter died a few years ago, he told her, and if he had not had insurance, the medical crisis would have bankrupted his family.

“You cannot give up on this,” she recalled his saying. The two held hands as her aides stood by.

It is moments like that, Sebelius said as she prepared for her final days as secretary, that leave her with satisfaction in spite of the political fallout from the Affordable Care Act, for her and the president.

“I was never terribly optimistic that this would be easy or not fraught with contentiousness,” she said. But, she added: “It was absolutely the right thing to do.”