With the Affordable Care Act’s rollout of open enrollment for 2014 deemed a “debacle” by President Obama’s own health secretary, Kathleen Sebelius, much attention has focused on the failings of a federal web portal long sold as the very symbol of the act’s accessibility.
The untold story is lack of continuity in implementing the act. Ever since the ACA was signed into law it has been a gold mine for those critical to helping the act succeed or fail.
In November 2011, I shared a stage in the venerable Willard Hotel in Washington, D.C. with Joel Ario, the Obama administration’s first head of the Office of Insurance Exchanges spearheading state exchange efforts.
In the federal bureaucracy’s labyrinth, the Office of Insurance Exchanges was part of the new Center for Consumer Information and Insurance Oversight created under the ACA. CCIO reports to the Centers for Medicare and Medicaid Services which, in turn, reports to the Department of Health and Human Services. If this confuses the layperson, he or she can be comforted to know it is no less confusing to regulators.
Ario was a former Oregon and Pennsylvania insurance commissioner. At the time of the forum we addressed, it had been announced that Ario was leaving his post in September to be closer to his family in Pennyslvania. Ario had been in the job since Aug. 30, 2010.
The Willard is where the term “lobbying” originated after patronage-seekers lined up in its ornate lobby to beseech President-elect Ulysses S. Grant for opportunities. And thus it was poignant that, a few weeks after Ario spoke there, a national lobbying firm announced Ario would be managing director of Manatt Health Solutions. Its clients include Aetna, the nation’s third-largest health insurer.
Having announced Ario’s departure, his boss, CCIIO Director Steve Larsen, Maryland’s former insurance commissioner, was next to go.
There was no statement that Larsen left to be closer to his family. Instead, he left in July 2012 to be closer to our nation’s largest health insurer, UnitedHealth Group, which he serves as executive vice president of subsidiary OPTUM. The multi-billion-dollar contract for the federal government’s Preexisting Conditions Insurance Plan, a bridge to 2014, was outsourced to UnitedHealth Group as well as — through its subsidiary Quality Software Services, Inc. — development of a critical part of the Healthcare.gov portal that has proved so disastrous. On Oct. 25, the Administration announced the company it was tasking as general contractor to fix mistakes made by QSSI and other vendors: QSSI.
After advising Montana Sen. Max Baucus during consideration of the ACA, Elizabeth Fowler went to work as a health care adviser to President Obama — where she made herself useful, according to media accounts, advising Wall Street investors hungry to know the direction ACA implementation was going. Fowler departed to take a job with health care giant Johnson &Johnson.
President Obama’s health reform director, Nancy-Ann DeParle, steered the president away from standing up to health care cost drivers. In August she became partner in a new private equity firm, Consonance Capital, guiding health care investments made more lucrative by her past decisions. A top adviser to Secretary Sebelius, Dr. Dora Hughes, became a “strategic adviser” for Sidley Austin — representing insurance, medical device, and pharmaceutical companies affected by the ACA.
The list goes on and on. Implementation for President Obama’s signature accomplishment would have gone better had its implementers rush to cash in been delayed until the act was actually implemented. Consumers and the administration have been ill-served by the ACA being treated as a get-rich-quick scheme by D.C. insiders.
Olympia attorney Brendan Williams is a frequent writer on health care issues.