Rough Market: Investigation into Health Care Solicitations Is Well Underway

Posted By: Dorkina Myrick, M.D., Ph.D.

As I mentioned in “To Market, to Market: Federal Funding for Health Exchange Implementation,” funding for instatement of the Affordable Care Act is inadequate at best. A brief description of some of the benefits and amenities offered by the Health Care Marketplace is included in my February blog post, “Affordable Care Act Implementation in 2013.” (1, 2) 

Both the New York Times and the Washington Post reported in May that the Secretary of Health and Human Services (HHS) had solicited funds from private entities to finance the marketing and implementation of health care exchanges. Ms. Sebelius acknowledged during a House Education and the Workforce Committee hearing that she had communicated with a total of five groups. Some of these organizations included the Robert Wood Johnson Foundation, H&R Block, and numerous other health care organizations, community organizations, and non-profit church groups. (3-5)

Video Courtesy of the House Education and the Workforce Committee

It seems that Ms. Sebelius’ hands were tied after Congress rejected numerous requests for increased funding to implement the Affordable Care Act (ACA). Although $1 billion was designated in the ACA for implementation, the reality is that between $5-10 billion is actually needed. Republican lawmakers have accused Ms. Sebelius of acting outside her official capacity in seeking the donations. The HHS Secretary has strongly disputed this, thus denying any wrongdoing. Ms. Sebelius emphasizes that she has not violated any official policies and that contact made with private entities regulated by HHS was not for the purpose of fundraising. Additionally, she states that her activities are justified and covered under the Public Health Service Act. (3,4,6)

Instead, these non-HHS entities were contacted on behalf of Enroll America, whose stated goal is that of a “nonpartisan 501(c)(3) organization whose mission is to maximize the number of uninsured Americans who enroll in health coverage made available by the Affordable Care Act. Enroll America is a collaborative organization, working with partners that span the gamut of health coverage stakeholders—health insurers, hospitals, doctors, pharmaceutical companies, employers, consumer groups, faith-based organizations, civic organizations, and philanthropies—to engage many different voices in support of an easy, accessible, and widely available enrollment process.” In fact, the website openly displays a “Please Donate” icon for all to see and utilize. (7)

Image Credit: istockphoto.com

However, Republican lawmakers continue to dispute the HHS solicitations and have launched an investigation into what they perceive as a conflict of interest. Consequently, the House Energy and Commerce Committee has sent letters to investigate not only to Enroll America, but also to Ms. Sebelius, herself, the General Accounting Office (GAO), and to 17 health care entities to obtain more information about the requests for money for Obamacare implementation. These include: Aetna, America’s Health Insurance Plans, Ascension Health, Blue Shield of California, BlueCross BlueShield Association, CareFirst BlueCross BlueShield, Cigna, Coventry Health Care, Inc., H&R Block, HCSC Group, Highmark, Humana, Inc., Independence Blue Cross, Johnson and Johnson, Kaiser Permanente, United Healthcare, and Wellpoint, Inc. (8)

Meanwhile, reports (referring to Enroll America) have circulated that “insurers feel pressure from [a] health group with ties to the White House” in the way of making obligatory donations. (9)

/PK

For more information and a brief overview, listen to the Kaiser Family Foundation podcast on this topic at “Sebelius Faces Questions About Calls to Outside Groups.”

References
1.  Myrick, Dorkina. “To Market, to Market: Federal Funding for Health Exchange Implementation.” PolicyKina. June 3, 2013. Website. https://policykina.com/2013/06/03/to-market-to-market-federal-funding-for-health-exchange-implementation/. Retrieved June 7, 2013.
2. Myrick, Dorkina. “Affordable Care Act Implementation in 2013.” PolicyKina. February 2, 2013. Website.  https://policykina.com/2013/02/02/affordable-care-act-implementation-in-2013/. Retrieved June 7, 2013.
3. Pear, Robert. “Cabinet Secretary Solicits Large Donations to Publicize Health Care Law.” The New York Times. Website. May 12, 2013. http://www.nytimes.com/2013/05/13/us/politics/health-secretary-raises-funds-for-health-care-law.html?_r=0. Retrieved June 6, 2013.
4. Kliff, Sarah. “Budget Request Denied, Sebelius Turns to Health Executives to Finance Obamacare.” The Washington Post. May 10, 2013. Website. http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/10/budget-request-denied-sebelius-turns-to-health-executives-to-finance-obamacare/. Retrieved June 6, 2013.
5.”Sebelius Answers Questions about Soliciting Private Funds to Implement ObamaCare.” House Education and the Workforce Committee. Website. June 4, 2013. http://edworkforce.house.gov/news/documentsingle.aspx?DocumentID=336569. Retrieved June 7, 2013.
6. Carey, Mary Agnes. “Sebelius Faces Questions About Calls to Outside Groups.” Kaiser Family Foundation. Website. June 4, 2013. http://www.kaiserhealthnews.org/Stories/2013/June/04/health-law-fundraising-sebelius-health-on-the-hill.aspx. Retrieved June 7, 2013.
7. “Enroll America: About Us-Our Mission.” Enroll America Website. http://www.enrollamerica.org/about-us. Retrieved June 6, 2013.
8. “Committee Expands Investigation into HHS Solicitations – Move Comes Following Sebelius Admission of Contacting Organizations that Agency Regulates On Behalf of Enroll America.” House Energy and Commerce Committee Press Release. June 4, 2013. Website. http://energycommerce.house.gov/press-release/committee-expands-investigation-hhs-solicitations-move-comes-following-sebelius-admission-contacting-organizations-that-agency-regulates. Retrieved June 6, 2013.
9. Baker, Sam. “Insurers Feel Pressure from Health Group with Ties to White House.” The Hill. May 23, 2013. Website. http://thehill.com/blogs/healthwatch/health-reform-implementation/301471-insurers-feel-pressure-from-health-group-with-close-ties-to-white-house. Retrieved June 7, 2013.