In April 2014, after months of criticism over the botched roll-out of healthcare.gov, part of his signature health care reform law, President Barack Obama stood in the White House rose garden and nominated a new person to be the public face of the Affordable Care Act.
Citing the “common sense that you see in small towns” like her home, Hinton, Obama called on Sylvia Mathews Burwell to fill the vacancy left when Kathleen Sebelius resigned from her post as secretary of the Department of Health and Human Resources.
“She’s a proven manager who’s demonstrated her ability to build great teams, forge strong relationships and deliver excellent results at the highest levels,” Obama said of Burwell. “And she’s done it both in the public and the private sectors.”
Burwell was the director of the Office of Management and Budget at the time. To those familiar with the Harvard graduate and Rhodes Scholar, her appointment to Obama’s cabinet wasn’t surprising, though her role might have been.
“It was not what I would have imagined as the first thing for her to do, given what she had done before,” said Burwell’s sister, Stephanie O’Keefe. “But when I thought about it, it made a lot of sense.
“She’s such a good strategic thinker and understands complex problems and is so incredibly good at engaging people in a way they feel their voices are heard and respected. That was something critically important. Her personality traits and skill set fit very well with what was needed in the job.”
The website, where people purchase health plans and a central part of the so-called “Obamacare,” had been marred by crashes and malfunctions.
The Hinton native had served as one of President Bill Clinton’s two deputy chiefs of staff, worked on Clinton’s National Economic Council and served for more than a decade for two billion-dollar charity nonprofit agencies, but her role as health secretary might have been the most challenging.
“You couldn’t have had a harder job,” Erskine Bowles, who worked alongside Burwell as a chief of staff to Clinton, said. “Obamacare had no support on the Republican side and lots on the Democratic side. For her to make the changes for it to work effectively, she had to get support on both sides of the aisle, and she had that ability.”
Burwell’s mother, Cleo Mathews, recalled talking to her daughter about the enormous challenge it would be to lead the department of Health and Human Services. She asked her daughter if she realized that.
“She said, ‘Well, it’s like if you’re in the military and your commander asks you to do something, you’re going to do it because it’s your patriotic duty,’” Mathews recalled her daughter saying. “She saw her government work as a form of patriotism.”
Childhood friend Terri Giles said Burwell has never been afraid of a challenge. It didn’t surprise Giles that Burwell accepted the tough role.
“If she thinks she can add something to the overall good, there’s no question,” Giles said.
For her lifetime achievements in the federal government and nonprofit sector, and for meeting that challenge to lead the implementation of the Affordable Care Act, a law by which about 200,000 West Virginians and millions of Americans gained access to health care, Burwell is the Gazette-Mail’s 2016 West Virginian of the Year.
Nearly 40 years later, Mathews still remembers seeing her daughter standing outside in her orange coat on a cold February day on the streets of Hinton. It was 1977 and Sylvia Mathews, like other West Virginia children, was out of school early after then-Gov. Jay Rockefeller declared a state of emergency due to an impending snow storm that would never materialize.
Mathews, a school teacher, had made it home. So had her other daughter, Stephanie. But there was no Sylvia when Cleo Mathews arrived. So she went back to the school to search the area for her daughter.
“I spotted [her in] that orange coat,” Mathews said. “So I drove up and put down the window and said, ‘What are you doing?’ and she said, “Oh, I’m selling Girl Scout cookies.
“Needless to say she sold the most cookies that February,” Mathews said.
Even as a little girl, Burwell “was always eager to do whatever was needed to be done,” her mother said.
Mathews and her late husband, Bill, emphasized public service to their daughters, bringing them along to various projects and activities in town.
“They grew up doing things for the community right along with us,” Mathews said.
The Mathews girls would trick-or-treat on behalf of UNICEF before they did for themselves. They collected money for the American Cancer Society.
O’Keefe, now the executive director of the International Women’s Forum, recalled her sister as a winsome child.
“She was just full of life and engaging and very charming,” O’Keefe said. “As she grew, she become more focused and disciplined. Early on, she decided she wanted to make a difference in the world.”
Burwell’s political career started early. As little girls, Burwell and her friends helped campaign for a friend’s father’s county commission run, and, as a 6-year-old, she helped campaign for Rockefeller’s failed 1972 bid for West Virginia governor.
Burwell and fellow Hinton native Giles, now executive director of West Virginians for Affordable Health Care, have been friends since childhood. The two attended Central Elementary School together, went to dance class and vacation Bible school together, Giles said.
“We were always there to pump each other up, to defend each other,” Giles said. “Sylvia has always been a rock and a foundation. I can’t remember a time when I didn’t know her and we weren’t friends.”
Giles said Burwell was a happy and friendly child.
“[She was] just a lot of fun to be around,” Giles said.
Hinton had a lasting impact on Burwell.
It started with the love she and other children felt from their community during that time, Mathews said.
Mathews recalled a local businessman who would call Burwell and other children and congratulate them on their academic achievements or when their names were in the local newspaper.
“It’s just the way the community worked,” Mathews said.
Giles attributes much of her success, and Burwell’s, to their community.
“She’s exceptional now, but we were ordinary young girls who had exceptional families and in an exceptional place in time in West Virginia,” Giles said. “This community made us.”
Burwell worked for a New York City consulting firm before joining Clinton’s 1992 presidential campaign and later serving on his National Economic Council.
Bowles, the former chief of staff to Clinton, called Burwell a “truly good” person.
“From my viewpoint there are few people I would describe as truly good and good to the bone, but that’s what Sylvia Mathews Burwell is,” Bowles said.
Bowles said Burwell got his attention while she worked as chief of staff for Treasury Secretary Robert Rubin. They were in a meeting together in the Oval Office. Whenever Clinton asked Rubin a question, Burwell would whisper the answer to Rubin, who would repeat it for the president.
Bowles remembers joking with Clinton that he had “broken the code.” If he could get Burwell to sit next to him, everyone would think he was as smart as Rubin, he said. Burwell didn’t ask for credit, but, often, when something got accomplished, it could be traced to Burwell, he said.
“I think she’s extraordinary, and she’s nice to boot — always has been,” Bowles said.
In 2001, Burwell started working for the Bill and Melinda Gates Foundation, where she spent a decade first as chief operating officer and then as president of the foundation’s Global Development Program. She left that position to become president of the Wal-Mart Foundation in 2012.
“Sylvia’s done a great job of helping us build a world-class organization and created a transformative grant-making program that is helping millions of poor people around the world,” Bill Gates, co-chairman of the Gates Foundation, said in a 2012 press release announcing Burwell’s departure. “She put our global development work on a path to success, and we look forward to building on it.”
Burwell then become director of Office of Management and Budget. In the fall of 2013, she led the office through a 16-day government shutdown after House Republicans refused to pass a budget unless the Affordable Care Act was defunded or dismantled.
It was Burwell herself who sent a memo that initiated the closure of national parks, visitors’ centers and monuments, according to media reports at the time. The shutdown cost $2 billion alone in lost productivity for furloughed workers, Burwell later wrote in a report.
“Sylvia was a rock, a steady hand on the wheel who helped navigate the country through a very challenging time,” Obama said in nominating Burwell to the health secretary post. “Once the government was allowed to reopen, Sylvia was vital to winning the two-year budget agreement that put an end to these manufactured crisis that we see here in Washington, so we could keep our whole focus on growing the economy and growing jobs and expanding opportunity for everybody who’s seeking opportunity.”
Giles said she and Burwell were not overly familiar with health policy before accepting their respective roles as health secretary and director of West Virginians for Affordable Health Care. Burwell has been able to grasp the details and intricacies of the Affordable Care Act, she said.
During a recent speaking event in Charleston, Burwell compared the ACA to a game of Jenga. If you removed one portion of the law, the entire thing could tumble.
“She has really grasped the minutia and details of this policy,” Giles said.
Denis McDonough, White House chief of staff, said the millions of people who have health insurance despite a pre-existing condition, those who have found treatment for an opioid addiction and those enrolling in health insurance for the first time have Burwell’s leadership to thank for it.
“Sylvia is a blessing and has worked tirelessly on behalf of West Virginians and all Americans to protect our public health and ensure every citizen has the opportunity to lead a healthy and productive life,” McDonough said in a prepared statement. “President Obama and his entire team are grateful for her extraordinary service to the nation.”
Ambassador Susan Rice, national security adviser, touted Burwell’s response to the Ebola and Zika outbreaks.
“Just months after taking office at HHS, Sylvia marshaled the nation’s response to the Ebola outbreak, not only ensuring the virus didn’t spread in the United States, but helping to lead a global response to contain the disease,” Rice said in a prepared statement.
“When Zika emerged as a threat in the Western Hemisphere, Sylvia led the charge, ensuring that health care workers and other responders across the country had the resources needed to protect American lives and fighting for the funding needed to respond and to develop a vaccine,” Rice said. “I have been fortunate to have her wise counsel and enduring friendship, and West Virginians should be proud of the tremendous work she has done on behalf of their state and this country.”
Bowles said Burwell would be remembered as health secretary because she took “a troubled organization, mired in controversy, and immediately made it work and work for the American people.”
But he doesn’t think Burwell’s work in public service is done. He said he would love to see her elected governor of West Virginia or president of the United States.
“I think her legacy is far from written,” Bowles said. “You haven’t seen the last of Sylvia Mathews Burwell in some sort of distinguished form of public service. She’ll have lots of opportunities. And wherever she goes, she’ll make a positive difference.”
Reach Lori Kersey at
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