Moreover, CNN senior political analyst Ron Brownstein said an Obama ally would not ultimately be confirmed, regardless of who was appointed.
There would be "virtual certainty" of a Republican filibuster as "an opportunity to use this as kind of a way to leverage more concessions from the administration," Brownstein, editorial director of National Journal, said Monday on CNN's "New Day."
Additionally, a confirmation hearing and debate in the Senate over a nominee would create another opportunity for Republicans to re-litigate the health care law.
It's a commonly used tactic in Washington. Republicans held up two nominees to head the new Consumer Financial Protection Bureau because they opposed the new agency designed to protect consumers and didn't want to see it running because they felt it put unfair burdens on business.
The president could avoid a confirmation fight by appointing an interim replacement, but there are political and practical risks with that as well.
Firing her won't fix it
In fact, it could make the situation worse.
Bringing in someone on a temporary basis to oversee the largest implementation of a government program since Medicare in 1965 could confuse the process.
Dr. Mark McClellan, former administrator for the Centers for Medicare and Medicaid Services, oversaw the bumpy roll out of Medicare's expansive Part D program. He said firing her "by itself wouldn't do anything."
Sebelius is the public face of the ACA. McClellan said she needs to "make sure there's an effective strategy to address the problem" as well answer questions for the public and Congress.
Obama has brought in additional help, including Jeffrey Zients, who is a noted management consultant, former White House budget official and the forthcoming director of the National Economic Council.
The appointment has been praised by some of the most critical Republicans.
"He's got a lot of managerial experience. He's been a consultant for the health care industry. I think he's got the right qualifications," Rep. Jeff Fleming, R-La., said Sunday on CNN's "State of the Union."
ACA hasn't failed yet
While the online roll out has been a disaster, the actual program hasn't failed. People have until March 31 to sign up to obtain health coverage for 2014.
"If people become more comfortable with the program, the outrage will recede," Dezenhall said.
"It's going to take a while to get people acclimated to managing their health care this way. I think there's going to be a lot of bed side manner, hand holding, and direction giving and that's going to take a while," he added.
Dezenhall cautioned, however, the scenario could change quickly and the administration should be assessing the situation constantly.
For instance, the program needs to enroll millions of the young and the healthy to keep costs down and enable the program to work.
"This is day by day," he said. "If the problems continue and they may, he may have to change his tone."