Sylvia Mathews Burwell confirmed to lead Health and Human Services

Sylvia Mathews Burwell.

WASHINGTON — The Senate today confirmed the nomination of Sylvia Mathews Burwell to be secretary of health and human services, which will make her responsible for delivering health insurance to more than one-third of all Americans.

Burwell was confirmed by a vote of 78-17. All the no votes were cast by Republicans. But 24 Republicans joined 52 Democrats and two independents in voting for confirmation.

Burwell, 48, has been director of the White House Office of Management and Budget since April 2013.

White House officials said that President Barack Obama selected her because he wanted a proven manager to carry out the health care law, which got off to a rocky start under Kathleen Sebelius as health secretary.

Sen. Tim Kaine, D-Va., strongly supported Burwell, saying Thursday that she had brought “a more businesslike approach” to the White House budget office and that she would do the same at the Department of Health and Human Services.

Burwell sailed through confirmation hearings before two Senate committees, where she mollified lawmakers with promises to be candid and cooperative in working with Congress.

The immediate task for Burwell is to defend the Affordable Care Act, a target of Republican criticism in many of this year’s midterm election campaigns.

The Senate Republican leader, Mitch McConnell of Kentucky, said Thursday that Burwell was, by most accounts, a smart and skilled public servant. But he said, as secretary, “she would be the chief operating officer of Obamacare implementation, a law that’s doing incredible damage to middle-class families.”

“Her embrace of this disastrous law is reason enough to oppose her confirmation,” McConnell said.

As secretary, she will also be responsible for Medicare and Medicaid, which insure more than 100 million Americans; the National Institutes of Health, the world’s largest biomedical research agency; and the Food and Drug Administration, whose decisions affect virtually every American on a daily basis.

Republicans said they hoped Burwell would address some of their concerns about the health care law.

Sen. Rob Portman, R-Ohio, said, for example, that hundreds of thousands of people were receiving incorrect health insurance subsidies because the federal government had not verified their income or eligibility. Solving this problem, he said, will require “new leadership from the top.”