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Administration Brings in More Management Expertise for Exchange Website

By Rebecca Adams, CQ HealthBeat Associate Editor

October 22, 2013 -- More information about the crisis management effort to clean up the website emerged Tuesday as the White House said incoming National Economic Council Director (NEC) Jeff Zients has temporarily joined the administration’s efforts to manage the salvage work.

But given the slow pace of improvements so far, there’s no guarantee the website will be performing flawlessly on Jan. 1, when current NEC director Gene Sperling is scheduled to leave the administration and Zients is supposed to replace him.

The administration is facing increasing pressure to fix the website more rapidly. The House Energy and Commerce will hold a hearing on Thursday with four government contractors who have worked on the launch. Health and Human Services (HHS) Secretary Kathleen Sebelius is expected to testify before the full committee on Oct. 30.

The agency is seeking to reassure frustrated insurers, medical providers, and supporters of the law (PL 111-148, PL 111-152) that it is doing all it can. Zients was called in as part of a team to bolster the force that is repairing the technical side of the administration’s top domestic priority.

Zients is an entrepreneur and former Obama administration budget official who was a top leader of the Advisory Board and the Corporate Executive Board from 1996 through 2004. He later founded the investment firm Portfolio Logic LLC before serving as the Obama administration’s chief performance officer and in short stints as the acting director of the Office and Management and Budget. His most recent posting there ended in April.

“We’ve also brought in additional experts and specialists drawn from within government, our contractors, and industry, including veterans of top Silicon Valley companies,” Sebelius said in a blog post Tuesday. “This new infusion of talent will bring a powerful array of subject matter expertise and skills, including extensive experience scaling major IT systems.”

The team also includes “a handful of Presidential Innovation Fellows,” Sebelius wrote, although HHS officials did not respond to requests to identify them by name. Chief Technology Officer Todd Parks is also working intensely on the effort.

Almost 20 million people have visited the website, President Barack Obama said Monday, but federal officials will not say until mid-November how many have enrolled.

One former Clinton administration OMB official said the personnel additions are a welcome change that could improve coordination, but added that if the technology does not improve and enrollment does not pick up, then the administration may consider adjusting some of the health care law policies — including the penalties for not having insurance.

People have until Feb. 15 to buy coverage without being at risk of having to pay a penalty. The administration has said about 2 percent of the U.S. population would be projected to pay the penalty in the first year for not buying insurance. For an individual, the fines are $95 or 1 percent of income, whichever is greater.

“If the administration is unsuccessful in getting enrollment up, they will start to push back the deadlines on the penalty,” said Dan Mendelson, who runs the health care consulting firm Avalere Health. “That will happen only if they can’t get enrollment on track by the end of November.”

Mendelson suggested that the administration could probably change the penalty by executive order.

Washington and Lee Law School professor Tim Jost has suggested that HHS could adjust the penalty administratively by expanding an existing exemption that the administration allows for people with hardships.

For now, Mendelson said, supporters of the law should do what President Obama did in a speech on Monday: encourage the public to sign up through the toll-free call-in center.

“The call center is really their best play right now,” said Mendelson. “Making that work is the most important thing and should be a central priority so there are no doubts people can sign up without accessing the website.”

Rebecca Adams can be reached at [email protected].

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