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Administration under pressure to appoint Obamacare CEO

Health Overhaul Keeping Score

(Reuters) - The White House is coming under pressure from some of its closest allies on healthcare reform to name a chief executive to run its federal health insurance marketplace and allay the concerns of insurers after the rocky rollout of Obamacare.

Advocates have been quietly pushing the idea of a CEO who would set marketplace rules, coordinate with insurers and state regulators on the health plans offered for sale, supervise enrollment campaigns and oversee technology, according to several sources familiar with discussions between advocates and the Obama administration.

Supporters of the idea say it could help regain the trust of insurers and others whose confidence in the healthcare overhaul has been shaken by the technological woes that crippled the federal HealthCare.gov insurance shopping website and the flurry of sometimes-confusing administration rule changes that followed.

The advocates include former White House adviser Ezekiel Emanuel, the brother of President Barack Obama's former chief of staff Rahm Emanuel, and the Center for American Progress, the Washington think tank founded by John Podesta, the president's newly appointed senior counselor.

The White House is not embracing the idea of creating a CEO, administration officials said.

"This isn't happening. It's not being considered," a senior administration official told Reuters.

Some healthcare reform allies say the complexity of the federal marketplace requires a CEO-type figure with clear authority and knowledge of how insurance markets work.

Obama's healthcare overhaul aims to provide health coverage to millions of uninsured or under-insured Americans by offering private insurance at federally subsidized rates through new online health insurance marketplaces in all 50 states and in Washington, D.C.

Only 14 states opted to create and operate their own exchanges, leaving the Obama administration to operate a federal marketplace for the remaining 36 states that can be accessed through HealthCare.gov.

The marketplace is now officially the responsibility of the U.S. Centers for Medicare and Medicaid Services (CMS) and its administrator, Marilyn Tavenner. Healthcare experts say there is no specific official dedicated to running the operation.

A CMS spokesman said exchange functions overlap across different groups within the agency's Center for Consumer Information and Insurance Oversight.

The lack of a clear decision-making hierarchy was identified as a liability months before the disastrous October 1 launch of HealthCare.gov by the consulting firm McKinsey & Co.

Obama adviser Jeffrey Zients, who rescued the website from crippling technical glitches last month, also identified the lack of effective management as a problem.


Former Microsoft executive Kurt DelBene has replaced Zients as website manager, at least through the first half of 2014.

"We're fortunate that Kurt DelBene is now part of the administration - there's no one better able to help us keep moving forward to make affordable, quality health insurance available to as many Americans as possible," Obama healthcare adviser Phil Schiliro said in a statement to Reuters.

The White House appears, for now, to be concentrating on ironing out the remaining glitches in HealthCare.gov to ensure millions more people are able to sign up for coverage in 2014. Good enrollment numbers are seen by both critics and supporters of Obamacare as a key measure of the program's success.

"So my sense is that they're not thinking about appointing a CEO in the short term," said Topher Spiro, a healthcare analyst with the Center for American Progress.

The CEO proposal calls for removing day-to-day control of the marketplace from the CMS bureaucracy and placing it under a leadership structure like those used in some of the more successful state-run marketplaces, including California.

The new team would be managed by a CEO, or an executive director, who would run the marketplace like a business and answer directly to the White House, sources familiar with the discussions say.

They point to insurance industry and healthcare veterans as potential candidates, including former Aetna CEO Ronald Williams, former Kaiser Permanente CEO George Halvorson and Jon Kingsdale, who ran the Massachusetts health exchange established under former Governor Mitt Romney's 2006 healthcare reforms. None of the three was available for comment.

Healthcare experts say the idea should have been taken up by the administration years ago.

"It's the right thing to do. It's just two years late," said Mike Leavitt, the Republican former Utah governor who oversaw the rollout of the prescription drug program known as Medicare Part D as U.S. health and human services secretary under President George W. Bush.

"The administration is confronted by a series of problems they cannot solve on their own. They do not possess internally the competencies or the exposure or the information," he told Reuters.

Emanuel, one of the administration's longest-standing allies on healthcare reform, recommended a marketplace CEO in an October 22 Op-Ed article in the New York Times, calling it one of five things the White House could do to fix Obamacare.

"The candidate should have management experience, knowledge of how both the government and health insurance industry work, and at least some familiarity with IT (information technology) systems. Obviously this is a tall order, but there are such people. And the administration needs to hire one immediately," he wrote.

The administration has adopted Emanuel's four other recommendations: better window-shopping features for HealthCare.gov; a concerted effort to win back public trust; a focus on the customer shopping experience; and a public outreach campaign to engage young adults.

(Reporting by David Morgan in Washington; Editing by Karey Van Hall, Michele Gershberg, Ross Colvin and Will Dunham)

Join the discussion

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gem46er December 29 2013 at 3:03 PM

CEO means Chief Executive Officer. As such, the current administration is reluctant to adopt any structure that would emulate a private corporation, or that would provide a business model to what the administration regards as a useful political entitlement.

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d.carns December 29 2013 at 2:03 PM

Well you can see by this thread what the real people think about Obama and his administration.
total worthless failure and destruction of America which is his goal. God help us!!!

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1 reply
King Of The Underdog d.carns December 29 2013 at 3:05 PM

d.carns, Wonder what part the previous 43 Presidents played in this mess that President Obama took charge of on January 20, 2009?

And we can't forget the worst Congress in our history! lead by the "obstructionist" Republican/Tea Party who writes the laws...

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1 reply
rsdealer56 King Of The Underdog December 29 2013 at 3:42 PM

Excuse me, But It was the Dems who wrote this law, Passed it without any input from Republicans. Did it with midnight backdoor deals, And rammed it through with even reading it. The Republicans tried to amend the law that would have fixed parts of it to allowed people like me to keep my plan at the price that I could afford and WITHOUT any government subsidy. Even that was voted down by every Dem.

Sorry But the tactic of trying to change the subject or blaming someone else won't work anymore. People have wised up to this administration.

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d.carns December 29 2013 at 2:01 PM

Obama and Democrats solution to everything, Throw more taxpayers money at all their screw ups.

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1 reply
ualfriend d.carns December 29 2013 at 2:20 PM

read my lips no new taxes does that ring a bell

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1 reply
rsdealer56 ualfriend December 29 2013 at 3:45 PM

read my lips. If you like your healthcare, you can keep your healthcare. PERIOD. If you like your doctor, you can keep your doctor. If you like your hospital you can keep your hospital. Does that ring a bell?

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sworth5487 December 29 2013 at 1:52 PM

No CEO! They demand huge salaries and even more huge bonuses for cooking the books. There are enough hands in the cookie jar as it is.

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marksatirv December 29 2013 at 1:48 PM

Obama needs more than a new CEO. He needs a brain transplant. The man has no leadership skills and no managerial skills. He has no experience running anything. He's just window dressing for leftist ideas, a hip spokesman who promotes socialism.

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1 reply
bedbugtoo marksatirv December 29 2013 at 2:09 PM

He is suggested to be a community leader, NOT.

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summerctz December 29 2013 at 1:47 PM

It doesn't need a CEO. It needs to be scrapped....

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1 reply
lanamm50 summerctz December 29 2013 at 1:49 PM

I agree...................Obama's Legacy will be that he was a failure as a President and his Obamacare only made things worse for us.

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1 reply
summerctz lanamm50 December 29 2013 at 2:04 PM

Absolutely! BTW, like your avi. lol

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ed27th December 29 2013 at 1:44 PM

Another Czar? I'm sure there are some unemployed Radical Socialists that fit the bill. They already shoved it down our throats, why are they still pushing it?

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1 reply
bedbugtoo ed27th December 29 2013 at 2:12 PM

Well all that voted for him...did you really want this much change? CAN U HEAR US NOW?

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cmax383666 December 29 2013 at 1:41 PM

I thougth OB could be the CEO since he believes in it so much and has forced it on promises.Let him be responsible.

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adrian December 29 2013 at 1:40 PM

He can appoint one of his community organizors friends who he owes a favor to.

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nkowalak December 29 2013 at 2:04 PM

One million people have signed up for the health care, six million have lost their health care. How many of the one million signed up for Medicad! I understood it would take six or seven million people before this program had a chance, NO, there is no need for another government position--the health insurance companies are all prepared to take over BIG TIME! We all have complaints--next time you vote, vote for someone who understands budgets!

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1 reply
bjredmond64 nkowalak December 29 2013 at 2:13 PM

none of it makes sense anymore. i wish obama would just take a hike. he has caused this country so much heartache. oh well, who am i? a down trod citizen of what used to be the greaatest country in the world.

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