Whitehouse.govAround this time last year, Health and Human
Services (HHS) Secretary Kathleen Sebelius came under fire for
making a series of calls to private companies and a foundation
requesting support for Enroll America, a non-profit organization
dedicated to boosting enrollment in health coverage under the
Affordable Care Act.
The calls were questionable because Sebelius was reportedly
calling companies that HHS regulated, and because Enroll America is
run by a former Obama administration campaign staffer and HHS
The Government Accountability Office (GAO) investigated the
incident and released its report to
the public yesterday. The report doesn't attempt to judge the
legality of the HHS secretary's actions, but focuses instead on
establishing the facts of the matter.
Here's the short version: Between January and April 2013,
Sebelius called five outside groups and requested that they provide
either financial or technical assistance to Enroll America. In the
months following the calls, one of those groups, the Robert Wood
Johnson Foundation (RWJF), gave Enroll America two grants totaling
Sebelius wasn't the only government official who spoke with RWJF
about supporting Enroll America. The former White House deputy
assistant to the president for health policy—Jeanne Lambrew, who is
identified in the report only by her title—also spoke with the
foundation about the need to raise $30 million to finance outreach
efforts surrounding the health care law. Lawbrew didn't name a
specific amount. But she "indicated a hope that RWJF would provide
a significant financial contribution to support such efforts."
Basically, the administration asked, and then, some time later,
Was there a relationship between the request and the funding?
The foundation claims there wasn't. An RWJF representative who
spoke to the GAO said that the "two grants were not made in
response to the Secretary's call." The foundation representative
also noted that RWJF had supported the creation of Enroll America,
and, prior to the call from Sebelius, provided an early grant for
the group's strategic planning.
Fair enough, I suppose: RWJF, a foundation that supports lots of
work in the health policy realm, had an existing relationship with
Enroll America, and it's certainly plausible that they might have
What the report really underscores, though, is how closely
linked the Obama administration is with Enroll America. The GAO
looked into whether HHS was aware that RWJF had donated following
the call from Sebelius, and HHS responded that while there was no
official tracking, staffers had heard about the donation. How did
they find out? From Enroll America, which told GAO that "they had
an ongoing relationship with HHS and likely discussed which
organizations had decided to contribute."
So Enroll America is an organization run by a former HHS and
Obama campaign staffer, dedicated to boosting participation in the
Obama administration's most prominent legislative achievement, and
which meets with senior White House officials and maintains an
ongoing relationship with a key administration agency. It's no
wonder the cabinet-level head of this agency makes fundraising
calls in support of this organization. It's practically an arm of
Is this arrangement uncommon? Perhaps in some of the
particulars, but in general, no, it's not entirely unusual for
administrations to work closely with friendly outside groups. But
it's rare to see the inner workings detailed so clearly.