The House voted in April to accept a system closer to the status quo over Shalala's recommendations, but the vote may be blocked by a presidential veto.

Because of the sensitive projects that Shalala deals with--which can create conflicts that go beyond party lines--she is often an easy target for protesters and political opposition.

"[The HHS secretary has] absolutely the most difficult position because you always have so many activist groups trying to reach you on everything from abortion to AIDS to welfare to animal rights," said former HHS secretary Dr. Louis Sullivan to Cleveland's Plain Dealer. "You get picketed and sued more than anyone else."

And Shalala, an ardent feminist, was one of several Cabinet members criticized for not walking out on the administration during the height of the Clinton sex scandal.

Shalala, however, says that her job was more important than the political attacks on Clinton.

"I think the Cabinet basically decided to stay," Shalala told The Times. "We had work to do."

"She cares about people and is supportive and loyal to the people she works with," Ellwood says.

She says she still has a good relationship with President Clinton.

"We're close," Shalala says. "We have a good working relationship."

Shalala, however, says that characterizing her department as controversial is a misnomer.

"It has a few controversial issues," she says. "Most of our budget has bipartisan support, and we usually receive more money that we ask for."

And despite the attacks, Shalala says she believes she has done her job well.

"American children are healthier and wealthier," Shalala says. "And American science is in a golden age."

Colleagues agree, saying she has provided direction for HHS.

"She is an amazing woman and a terrific manager," Solomon says.