The U.S. Senate voted in Sylvia Matthews Burwell as the new Secretary of Health and Human Services on Thursday afternoon. 

Burwell, the former head of the Office of Management and Budget, was confirmed 78-17. Before and after the vote, Burwell both faced her share of fire and garnered high praise.

So now the pressure is on.

“Sylvia is a proven manager who knows how to deliver results, and over her career she has built deep relationships with Democrats and Republicans alike,” President Obama said after the vote. “I’m confident Sylvia’s unparalleled experience will serve her well in her new role as she works to ensure the safety of our food and drug supply, protect our nation from outbreaks or bioterror attacks, keep America at the forefront of medical research, and make sure every American has access to quality, affordable healthcare.”

[See also: HHS nominee Burwell gets Senate hot seat.]

That last item, which can be translated as driving continued implementation of the politically-contentious Affordable Care Act against the backdrop of a rough start to Healthcare.gov and ongoing Medicaid expansion in the states, will likely be the most difficult in the days ahead.

Indeed, Republican opponents began striking out at Burwell prior to the vote, with Senate Minority Leader Mitch McConnell saying on the Senate floor that “her embrace of Obamacare calls her policy judgment into question. And when it comes to the task of implementing this ill-conceived and disastrous law, the President may as well have nominated Sisyphus because Ms. Burwell is being asked to do the impossible here.”

Early industry reaction was positive.

"HIMSS looks forward to working with Sylvia Matthews Burwell to continue supporting the transformation of healthcare through IT,” said Tom Leary, vice president of government relations at HIMSS, the Healthcare Information and Management Systems Society, parent company of Government Health IT. 

Burwell is slated to officially take over for outgoing Secretary Kathleen Sebelius after a swearing in ceremony on Monday, according to reports.

[See also: Sebelius quits after HealthCare.gov mess.]