Sylvia Mathews Burwell has a big task ahead of her.
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The outgoing White House budget official is poised to take the reins of one of the largest bureaucracies in the United States as it implements ObamaCare, the most sweeping new social program since Medicare.
But as President Obama’s nominee to head the Department of Heath and Human Services (HHS), Burwell would have more on her plate than just the healthcare law.
The HHS secretary is in charge of a volatile mix of programs, politics and stakeholders that makes it among the hardest of all the Cabinet positions.
The job is a magnet for partisan attacks, and Burwell would assume her new role in a high-stakes election year when Republicans hope to use the healthcare law to take back the Senate.
Parts of the health department are mired in dysfunction, adding to the difficulties.