Kathleen Sebelius stands with Sen. Pat Roberts (right), R-Kan., and former Senate Majority Leader Bob Dole in 2009.
This month's government shutdown grew out of Republicans' insistence on a budget that defunded the Affordable Care Act.
That didn't happen, but Republicans still detest the law — and now there's a movement underway to oust Health and Human Services Secretary Kathleen Sebelius.
What's unexpected is that the effort is being led by a senator from Sebelius' home state, Kansas Republican Pat Roberts — someone she's long had close family and professional ties to.
Sebelius had served six years as governor of Kansas before she came to Washington at the start of the Obama administration. When she did so, no one seemed prouder than Roberts.
"It is a special and great opportunity for ... a Kansan to be represented as a member of the president's Cabinet," Roberts said at Sebelius' confirmation hearing in 2009.
Roberts described their "special relationship," going back decades. But now, more than four years later, his tone has changed.
In a YouTube video last week, Roberts responded to the troubled rollout of the new health insurance exchanges and the technical problems people have encountered while trying to sign up online.
"Enough is enough," he said. "Today I am calling on Kathleen Sebelius to resign her post as secretary of Health and Human Services. Secretary Sebelius has had three and a half years to launch Obamacare, and she has failed."
Now, it's hardly news that a Republican member of the Senate is criticizing a Cabinet official from the Obama administration. What's interesting here is that Roberts is showing such animosity toward someone with whom he has had such a close relationship.
It's one that goes back to before either held public office, says University of Kansas political scientist Burdett Loomis.
"There's this combination of the personal and the political," Loomis says. "Pat Roberts began his political career working for Keith Sebelius, congressman from western Kansas. He subsequently succeeded Keith Sebelius in that job."
And Keith Sebelius, a Republican, is the father-in-law of Democrat Kathleen Sebelius.
As officeholders, Loomis says Kathleen Sebelius and Roberts have long worked well together.
But he also notes that as Kansas has become a reliably red state, its Republican Party has gotten much more conservative. He adds that Obamacare is extremely unpopular there, so there's plenty of motivation for Roberts to distance himself from — and even lead the effort against — an old friend.
"He's moving with the times," Loomis says. "He's doing what savvy politicians do. And I think that as he approaches this next term — he'll be 78 when he runs for re-election — I think that he doesn't want to have any impediments in his way."
Roberts does have a primary opponent in 2014 — Milton Wolf, a Tea Party candidate who happens to be President Obama's second cousin. (As NPR's Adam Wollner has reported, Wolf's mother was Obama's grandmother's cousin, and Wolf's and Obama's mothers were childhood friends in Kansas.)
Wolf is considered a long shot, but Loomis says Roberts appears to be taking no chances in the wake of Tea Party defeats of other veteran Republican senators, such as Richard Lugar of Indiana.
Sebelius, meanwhile, has not responded to Roberts. She has acknowledged that the launch of the HealthCare.gov exchange website was "rockier than we would have liked."
There was "lots and lots and lots of interest and difficulty getting people on the site and getting them to the plans," she said in Cincinnati this week.
But Sebelius got a strong vote of support from the White House. And adding to her job security is the fact that nominating a new Health and Human Services secretary would mean another confirmation hearing — and another avenue for Republicans to attack the health care law.