Sebelius Thrust Into Firestorm on Exchanges

The first, and perhaps most painful, call for Kathleen Sebelius to resign as President Obama’s health secretary came this month from an old family friend: Senator Pat Roberts, Republican of Kansas, who once boasted of a “special relationship” with Ms. Sebelius, forged when he worked for her father-in-law.

Now Ms. Sebelius, the former Kansas governor who is the public face of Mr. Obama’s health care overhaul, is facing a barrage of criticism over the problem-plagued rollout of its online insurance exchange. For Republicans, still reeling from their failed “defund Obamacare” strategy and government shutdown, she has proved an easy target.

Republicans insist the buck stops with the secretary. But although Ms. Sebelius runs the Department of Health and Human Services, the agency directly responsible for the health care law, there are questions about how deeply she was involved in the development of the troubled Web site.

“Kathleen has the title, but she doesn’t have the responsibility or in many respects the kind of wide authority and access to the president that she really needs to make a difference,” said one person close to Ms. Sebelius and the White House, who asked to remain anonymous to discuss internal decision-making. “Everybody thinks that she’s the driving force, but unfortunately she’s not.”

The White House kept close tabs on the creation of the online exchange, with particular attention to the Web site’s design, but managing the details of the software development was left to the Centers for Medicare and Medicaid Services, which Ms. Sebelius oversees. She testified on Capitol Hill this spring that the exchanges were “on track” to open on Oct. 1, but those close to her say she has been far more immersed in developing policy related to the health care law, and in traveling the country to promote it, than in its technical aspects.

Ms. Sebelius’s decision to leave Washington this week — she will speak at a gala at the John F. Kennedy Presidential Library and Museum in Boston on Wednesday night, then travel to promote the health care law in Phoenix; Austin, Tex.; and San Antonio — caused an uproar among Republicans who said she has not explained why the Web site failed and how the government plans to fix it.

House Republicans, including leaders of the Energy and Commerce Committee, which planned a hearing on Thursday to examine issues related to the technical failures of the Web site, have demanded that she testify. (She will do so next week.)

“We’ve got lots of questions,” said Representative Joe Pitts, Republican of Pennsylvania and chairman of the panel’s health subcommittee. “Why would she mislead us so shortly before the rollout, when they were obviously not prepared and are still not prepared, and it’s going to take a long time to fix the problem? We want to know how long she thinks it is going to take.”

On Tuesday, Ms. Sebelius tried to provide some answers, at least in writing. In a blog post on her agency’s Web site, she provided details of the “technology surge” promised by the White House to correct the site’s deficiencies, and she named Jeffrey D. Zients, a management consultant and administration veteran with a history of resolving government technology issues, as leader of the effort. She said the administration also is bringing in “veterans from top Silicon Valley companies” and other experts to consult on the technology overhaul.

Though Republicans are increasingly calling for her resignation, Ms. Sebelius has not addressed her future. Allies have said she has no intention of stepping down; the White House supports her. “She has the president’s confidence,” Denis McDonough, the White House chief of staff, said in an interview on Tuesday. “And she knows that.”

But even her Democratic defenders agreed that the secretary did not help herself with a fumbling appearance this month on “The Daily Show With Jon Stewart.” Mr. Stewart began the show by pulling out a laptop computer and declaring, “I’m going to try and download every movie ever made, and you’re going to try and sign up for Obamacare, and we’ll see which happens first.”

For Ms. Sebelius, the interview went downhill from there; soon Republicans were gleefully circulating video clips to reporters. Rush Limbaugh, the conservative radio host, said she looked “ignorant, misleading and totally incompetent.” Even Mr. McDonough did not defend the performance, saying only, “I thought it was tough.”

The secretary, who declined to be interviewed, has kept a low television profile since then, prompting questions about whether the White House was keeping her under wraps, though she has taken questions at community events. Tuesday night, she sat for an interview with Dr. Sanjay Gupta of CNN, which promoted the appearance on Twitter, asking, “What went wrong w #Obamacare website? Will she resign?” She dodged the question twice.

The ruckus over Ms. Sebelius, who is 65, may have roots in Kansas politics, where she rose to prominence as a daughter of a governor (John J. Gilligan of Ohio) and the daughter-in-law of a congressman, Keith Sebelius, a conservative Kansas Republican.

<p class="MsoNormal”>Mr. Roberts, the Kansas senator, was Mr. Sebelius’s longtime chief of staff and succeeded him as his “handpicked replacement,” said Todd Tiahrt, a former Kansas congressman. But Mr. Roberts is facing a primary challenge from a Tea Party activist, so his break with Ms. Sebelius was no surprise.

“If she was running a private company that had this kind of meltdown at the start-up, she’d be replaced,” Mr. Tiahrt said. “So I think he’s justified in calling for her resignation, but it’s also good politics in Kansas.”

Ms. Sebelius has been at Mr. Obama’s side since 2007, when she was governor and he was challenging Hillary Rodham Clinton for the Democratic presidential nomination. Ms. Sebelius endorsed him in January 2008.

Mr. Obama admired her as “a very successful governor in a red state,” said David Axelrod, his former senior adviser. As a former insurance commissioner, she was eager to be health secretary, he said. “She anticipated that he would do health reform,” Mr. Axelrod said. “That was the attraction to her.”

Getting the Web site running was only one component, albeit a very public one, of Ms. Sebelius’s work to carry out the Affordable Care Act. After the bill became law in 2010, she began holding weekly meetings on a range of thorny regulatory and policy issues, like how to define the “essential health benefits” provided by insurance plans or what to do about a possible shortage of primary care doctors.

She also set out to sell the public on the program; Mr. McDonough praised her as “tireless” in that effort. While he described the health secretary as the law’s “lead implementer, with support from all of us,” he would not discuss her work with respect to the Web site, saying that those were questions best directed to her.

It is not Ms. Sebelius’s first brush with controversy. A federal judge once criticized her over the decision to restrict morning-after contraceptive pills to teenagers, calling it “politically motivated.” She also faced scrutiny from Republicans for her fund-raising work for Enroll America, a group promoting the health law.

Those close to her say she views the measure as part of her own legacy as well as Mr. Obama’s. After helping to get it passed and seeing it through a Supreme Court challenge, she does not appear to be going anywhere. “They ran it up the flagpole all the way to the Supreme Court,” Mr. McDonough said Tuesday, “and the law is still standing, and so is she.”

http://www.nytimes.com/2013/10/23/us/politics/sebelius-thrust-into-firestorm-on-exchanges.html?_r=1&

By SHERYL GAY STOLBERG

Published: October 22, 2013

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