The luxury of working for President Obama appears to be that you can be involved in one of the most gargantuan screw-ups in the history of Washington and still not have to worry much about losing your job.
What else are we to think when 4 states have now summarily fired the people in charge of their Obamacare exchanges for far less cause than the federal bureaucrats who continue to pull down paychecks and take up space at HHS?
Heads of four state-run health insurance marketplaces have stepped down amid persistent technical headaches and questions about leadership since Obamacare enrollment began Oct. 1. In contrast, virtually everyone tied to HealthCare.gov’s bungled rollout has held onto their jobs, except for one Centers for Medicare & Medicaid Services official who abruptly jumped ship for the private sector.
The leadership changes in Hawaii, Maryland, Oregon and now Minnesota have come as tech woes have significantly undermined enrollment targets in states that were expected to be pacesetters in expanding coverage under President Barack Obama’s signature health law.
Oregon’s exchange is still only taking paper applications, Hawaii’s website launched two weeks late, and Maryland – once thought to be a model for Affordable Care Act implementation — has delivered a frustrating enrollment experience.
Exchange director “is a tough job and a high-pressured job,” observed Alan Weil, executive director of the National Academy for State Health Policy.
The job also comes with plenty of accountability, especially in states that have embraced the health law and must be responsive to very local constituencies. The federal government is slogging through the technological disaster with a more bureaucratic response as it works to repair the website rather than focus on who broke it.
“The fact that they are slowly but surely getting the kinks out of the system probably obviates the need to have a public hanging,” said Elaine Kamarck, a former President Bill Clinton aide and founding director of the Brookings Institution’s Center for Effective Public Management.
The White House over the past couple of months has consistently pushed back against questions about who might lose their jobs over HealthCare.gov’s disastrous rollout. The focus, they say, is on getting everything working right for the federal portal, which serves 36 states that refused or were unable to set up their own exchanges.
The states haven’t been so patient.
Incredibly, two of the ousted state exchange managers were let go following revelations that they took Thanksgiving trips to tropical islands.
That’s the case in Maryland, where Gov. Martin O’Malley and Lt. Gov. Anthony Brown were eager to set the pace for ACA implementation in the country. Instead, the state’s first exchange director stepped down this month after a two-year run, and Brown’s 2014 gubernatorial campaign has taken hits from Democratic opponents who’ve criticized the faulty exchange.
Minnesota’s exchange, known as MNsure, has been working better than most. But it, too, has its glitches, including long waits at the call center and inaccuracies in the applications transmitted to insurers. Executive Director April Todd-Malmlov resigned on Tuesday amid growing criticism over the technical problems, compounded by her decision to take a Costa Rica vacation in the middle of it all.
The head of the Maryland exchange, Rebecca Pearce, was fired following published reports that she took a trip to the Cayman Islands during Thanksgiving — despite continuing problems with the website.
No doubt the Obama administration has made a list and is checking it twice of employees who will be canned when the brouhaha over the website calms down a bit. But wouldn’t firing those people immediately have sent a message that incompetence wouldn’t be tolerated?
It also begs the question: Why should people who screwed up the website in the first place be in charge of fixing it?