Member of Parliament, 1999–2011

In 1999, De Block nominated herself for the federal election as member of the liberal party Vlaamse Liberalen en Democraten also known as VLD.^[5] During the elections, she was elected as a Member of the Belgian Chamber of Representatives for the electoral district Brussels-Halle-Vilvoorde.

Early career in government, 2011–2014

Four years after the election she became Secretary of the Chamber of Representatives for four years. In 2010, De Block also became Chairman of the Infrastructure Committee until the following year.^[6] De Block was chosen to become Secretary of State for Asylum, Immigration, and Social Integration in the newly Di Rupo Government which would be formed in December 2011.^[7] On 6 December, she becomes Secretary of State for Asylum, Immigration, and Social Integration and part of the Federal Government.^[8][9]

In December 2012, De Block became the vice-chair of the Open VLD party.^[10] In March 2013, she was voted woman of the year by readers of the francophone newspaper La Libre Belgique.^[11] In 2013, and 2014 polls, she became the most popular Flemish politician, ahead of the Minister-President of Flanders Kris Peeters.^[12]

De Block became Minister of Justice charged with Asylum, Immigration, Social Integration, and Poverty Reduction in the Di Rupo Government in July 2014.^[13]

Minister of Health, 2014–2020

In the government of Prime Minister Charles Michel formed in October 2014, De Block became Minister of Social Affairs and Health. When taking the oath, she described the portfolio as "her dream".^[14] Critics have said that she does not set the right example as Health Minister due to her obesity, and she has answered that "I know I'm not a model but you have to see what's inside, not the packaging".^[15]

During her time as minister, De Block was involved in coordinating the Belgian response to the Ebola virus epidemic in West Africa.^[16] In 2015, she led a joint effort of Belgium and the Netherlands to negotiate the purchase of remedies for rare diseases with pharmaceutical groups.^[17] In June 2015, she signed a royal decree legalising certain uses of medical cannabis, which at the time only included Sativex oral spray for multiple sclerosis.^[18]

By 2015, De Block was the most popular politician in Flanders, Wallonia and Brussels, making her the most popular politician in Belgium.^[19]

In 2018, under De Block direction as health minister, the strategic reserve of FFP2 masks was destroyed because of being out of date and not replenished.^[20] She claimed she did not replenish them to save taxpayer money. This decision came under fire during the COVID-19 pandemic when the shortage of masks contributed to make Belgium one of the hardest-hit countries.^[21][22]

In September 2018, De Block decided to introduce plain packaging for all tobacco products in Belgium.^[23]

On 9 December 2018, it was announced that De Block would be responsible again for Asylum and Migration, replacing Theo Francken.^[4][24] She held the post in a previous government.^[25] Her official title in the caretaker Michel II government and in the succeeding Wilmès government was Minister of Social Affairs and Public Health, and Asylum Policy and Migration.^[26]

During the early phase of the COVID-19 pandemic in Belgium, De Block oversaw the government's response. In May 2020, she called on European Union countries to be “united” in the distribution of protective face masks.^[27] By July 2020, she publicly cited the lack of greater coordination with Belgium's neighbours – France, Germany and the Netherlands – as a “big concern”.^[28]

De Block was not re-appointed to the government led by Alexander De Croo and instead became a regular member of the Belgian Parliament again.^[29]