We have seen this movie before.

When passing Obamacare in the first instance, the government co-opted the health care and insurance companies it regulated and would regulate into supporting the bill. Their cooperation was critical.

Fast forward to the Obamacare sign-up problems. A key player has been the private Enroll America, which itself has not been without controversy. Enroll American obtained substantial funding from private insurers who had been solicited directly by Kathleen Sebelius to make the donations.

The Washington Post reported back in June:

Sebelius told members of Congress that she has made five outreach calls on behalf of Enroll America, a new organization that aims to increase public participation in the Affordable Care Act.

“Three were to discuss the organization and suggest the entities look at the organization,” Sebelius testified at a House hearing Tuesday. The other two phone calls, to officials at the Robert Wood Johnson Foundation and H&R Block, were direct solicitations for fundraising. Sebelius said that she did not request a specific level of donation from those two companies.

The secretary’s outreach on behalf of the nonprofit came after Congress repeatedly denied requests from her agency to increase funding for the health care law. Without those additional funds, the department has said it lacks the resources to run a full-fledged campaign explaining the law to the public and promoting enrollment.

Sebelius has come under heavy criticism from Republicans for her fundraising work for Enroll America. Some argue that she is circumventing the wishes of Congress, and others have worried that she is pressuring companies that are regulated by her agency. Sen. Lamar Alexander (R-Tenn.) has described the secretary’s efforts as “arguably an even bigger issue” than the Iran-Contra Affair.

Sebelius defended her actions Tuesday, saying that she has placed phone calls to Johnson & Johnson, which manufactures health care products, and Ascension Health, a Catholic hospital system.

The secretary also had a conversation about Enroll America with George Halvorson, chief executive of Kaiser Permanente, a California-based health insurer.

The NY Times reported yesterday that the effort went beyond the calls also included requests to insurance companies directly regulated by Sebelius to give technical assistance to Enroll America:

She also requested “nonfinancial support, such as technical assistance, from Ascension Health, Johnson & Johnson and Kaiser, which consists of the Kaiser Foundation Health Plans and Kaiser Foundation Hospitals.” …

The report notes that the Health and Human Services Department regulates Kaiser, Ascension and Johnson & Johnson.
A spokesman for Senator Lamar Alexander, Republican of Tennessee, one of five lawmakers who had requested the report, said the senator hoped Ms. Sebelius’s replacement “will not ask the entities she regulates to support the president’s allies.”
Health and human services officials told investigators that they were not aware of any federal employees outside their agency who had solicited funds on behalf of Enroll America.
However, the report says a Robert Wood Johnson Foundation employee told investigators of a 2012 conversation in which a White House official “indicated a hope that R.W.J.F. would provide a significant financial contribution to support” Enroll America.
The report identifies the official as the deputy assistant to the president for health policy, but does not give her name, Jeanne M. Lambrew.
The foundation said the White House had estimated that groups like Enroll America would need $30 million. It said it had made grants to Enroll America totaling $13 million, but denied they were in response to the secretary’s call.

When the Secretary of HHS calls a company HHS regulates to “ask” for help, it’s a shakedown because of the unequal power relationship.


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