Thursday, August 28, 2014

Major liberal think tank wants new Obamacare management

CAP president Neera Tanden wrote the memo urging the White House to name an Obamacare chief executive Scott J. Ferrell/CQ-Roll Call Group

A major liberal think tank wants an Obamacare management shake-up.

The Center for American Progress published a memo Saturday calling on the White House to change the way it manages the Affordable Care Act. The biggest change CAP proposed was creating a chief executive to oversee, someone who could be a point-person for managing the online marketplace moving forward.

"There is still no single leader who is accountable for successful implementation of the Affordable Care Act," CAP president Neera Tanden, former Obama administration official Zeke Emanuel and Topher Spiro, who runs CAP’s Center for Health Policy, write.

Over the three years that the Obama administration spent building, there wasn’t really one person specifically in charge of the website. There were lots of parts of the federal bureaucracy involved in the project including the White House, Health and Human Services and the Centers for Information and Insurance Oversight (a division of HHS).

That changed with the website’s botched launch. The White House began appointing temporary leaders to help manage the website in a period of crisis, including former Office of Management and Budget director Jeff Zients and, currently, former Microsoft executive Kurt DelBene. The idea would to be make these positions more permanent — and also add two advisory committees that would report to the hypothetical executive.

As the CAP report points out, this is the management structure that the 15 state exchanges use, each with a chief executive in charge of the effort and multiple advisory committees with specific areas of expertise. This model hasn’t always been successful: both Oregon and Maryland, for example, had one leader at the top of the chain of command. And both of them had pretty disastrous launches. However, most of the state exchanges did have better rollouts than the federal law.

The White House says it will consider the proposal.

"We are working to make sure we learn from implementation and the turnaround of," White House spokeswoman Jessica Santillo says. "While we have not reviewed this specific proposal, we will consider all ideas to improve implementation."

In the meantime, you can read the full CAP memo here.

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