Around 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 political appointee.
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 $13 million.
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, RWJF gave.
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 donated anyway.
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 the administration.
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.