President Obama picked Sylvia Mathews Burwell to be the new face of health care because she has dealt with the complexities of the federal budget and has managed large organizations.
One other thing: Burwell is a good bet for Senate confirmation.
Just a year ago, the Senate voted by a 96-0 margin to confirm Burwell to her current job, director of the Office of Management and Budget.
Now Burwell, to be nominated by Obama to replace Kathleen Sebelius as secretary of Health and Human Services, will undergo new Senate confirmation hearings focused on Obama's disputed health care law, and Republican attacks on it.
At this point, at least, Burwell has much better relations with Congress than the embattled Sebelius.
"Sylvia Burwell is an excellent choice to be the next #HHS Secretary," tweeted one prominent Republican, Sen. John McCain of Arizona.
When Obama nominated Burwell to be OMB director last year, he cited a resume that included high-ranking jobs with the Clinton administration, Walmart and the Gates Foundation.
"Sylvia knows her way around a budget," Obama said.
In recent months, Obama has praised Burwell's performance in negotiations that ended the partial government shutdown in October and led to a two-year budget agreement with Congress.
As OMB director, Burwell was technically the official who ordered the shutdown after Congress could not agree on a new spending plan.
White House Chief of Staff Denis McDonough told The New York Times that Obama regards Burwell as "a proven manager and relentless implementer," qualities that will be important as she oversees continuing development of the complex new health care law.
A staff member throughout her government career, Burwell figures to be a lower-key Cabinet secretary than than the higher profile Sebelius, a politician who once served as governor of Kansas. Sebelius faced heavy criticism over the rollout of the new health care law, particularly the website problems that blocked early sign-ups for policies.
If confirmed by the Senate, Burwell faces a number of health care challenges. Provisions that have been delayed are scheduled to come on line, including the requirement that employers provide health insurance to their workers.
The administration hit its goal of more than 7 million sign-ups when this year's enrollment period ended March 31. A new enrollment period begins later this year, and Republicans are claiming that premiums will rise as financial pressures burden the new system.
Senate Minority Leader Mitch McConnell, R-Ky., said he hopes Burwell's nomination -- "to lead one of the most important jobs in government" -- will be "the start of a candid conversation about Obamacare's short-comings and the need to protect Medicare for today's seniors, their children and their grandchildren."
While she has spent much of her career as a government staffer, Burwell does have something of a political background. Her mother served as the mayor of Hinton, W.Va.,where she was born in 1965.
A Harvard graduate and a Rhodes Scholar, Burwell did several jobs during the Bill Clinton presidency. She served as chief of staff to Treasury Secretary Robert Rubin and deputy chief of staff to Clinton himself. She was deputy OMB director to then-budget director Jack Lew, now Obama's Treasury Secretary.
Burwell also has experience in the private sector. She worked at the Bill & Melinda Gates Foundation, which develops global health and anti-poverty programs. Burwell has also been president of the Walmart Foundation, the charity arm of the retail giant.