In 2010, shortly after President Obama’s health care legislation was signed into law, I dubbed Health and Human Services Secretary Kathleen Sebelius the “Empress of Obamacare” for the vast new powers she inherited. Reading through the text of the law, I counted more than 2,500 references to the secretary of HHS, of which more than 700 referred to instances in which she “shall” do something and more than 200 cases in which she “may” take regulatory action.