Obamacare: Fight Among Supporters Over Going Private


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Bring in the private sector — that’s apparently the rallying cry for some Obamacare supporters who want the White House to appoint a CEO to head the federal marketplace.

Reuters reports some Affordable Care Act allies are calling for a CEO who would be in charge of establishing rules for the marketplace, overseeing enrollment, collaborating on health plans with insurers and state regulators, and managing technology. The news service spoke to sources who are familiar with the discussions.

The thinking is that a private sector leader would lend credibility to the program and assuage public doubts stemming from the rollout of HealthCare.gov. So far, the White House isn’t taking the bait. ”This isn’t happening. It’s not being considered,” one senior administration official said to Reuters.

This isn’t the first time those close to the president have advocated taking this route. In October, Ezekiel J. Emanuel penned a column for The New York Times outlining fixes for Obamacare glitches. Emanuel is a former health care policy adviser for President Obama. One of the reforms he called for was “a new position: an independent chief executive of the federal exchange.”

Emanuel continued in his piece for the Times: “This C.E.O. should meet one on one with the president every week to ensure he or she has full authority to carry out the job. The candidate should have management experience, knowledge of how both the government and health insurance industry work, and at least some familiarity with IT systems. Obviously this is a tall order, but there are such people. And the administration needs to hire one immediately, while [Jeffrey] Zients works to put out the fires.”

Outsiders have also questioned the government-only strategy. NBC’s David Gregory was interviewed by Larry King in December. Gregory said he did not understand why the president used a private company — according to him, the sector best equipped to handle such projects — for his campaigns but governmental entities for HealthCare.gov.

The idea for private involvement has support, but few think it is likely to happen. Topher Spiro, a health care analyst with the Center for American Progress, said to Reuters, “my sense is that they’re not thinking about appointing a CEO in the short term.” Rather, the administration will focus on highlighting enrollment numbers and removing any remaining technical barriers.

The marketplace is currently facilitated by the Centers for Medicare and Medicaid Services. A report by consulting firm McKinsey & Co. outlined for the administration ahead of the launch why no clear leadership could lead to potential failures for the website. NPR provided a copy of the slides shown during the presentation.

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