WASHINGTON – Congressional Republicans have opened a new line of attack on President Barack Obama's health care law, charging that the administration has improperly sought help from the health care industry and other outside groups to implement the landmark statute.
Health and Human Services Secretary Kathleen Sebelius for months has been asking foundations, consumer and business groups, insurance companies and others to help enroll uninsured Americans in health insurance this fall, a key goal of the Affordable Care Act. Administration officials say those actions were entirely appropriate.
The effort has included suggestions in several cases to make financial contributions to a nonprofit organization called Enroll America, created in 2010 to support the enrollment push.
The health care law provided some money for implementation, including funds to help publicize the new benefits that it provided. Administration officials consider public outreach essential to getting young and healthy consumers to sign up for health coverage next year when it will be guaranteed to all Americans for the first time. If only older, sicker people sign up for insurance, premiums could go up substantially.
Republicans in Congress have tried to block money to help publicize the law. The administration, in turn, has relied more heavily on private companies and nonprofit groups to do so.
Long-standing federal law prohibits departments from seeking outside money to do work that has not been provided for in funds appropriated by Congress. But the law does not prohibit a department or agency from collaborating with the private sector as long as the agency does not direct work that is paid for privately in lieu of a congressional appropriation.
Another law, the Public Health Service Act, allows health secretaries to encourage support for nonprofit groups "working in health information and health promotion, preventive health services and education in appropriate use of health care."
Health and Human Services spokesman Jason Young said no health care companies were solicited for donations.
"The secretary has made no fundraising requests to entities regulated by HHS," he said.
But the secretary's fundraising, first reported by The Washington Post, is now drawing calls for an investigation from GOP lawmakers who have been trying to block implementation of the president's health care law since it was enacted in 2010.
"Secretary Sebelius' fundraising for and coordinating with private entities helping to implement the new health care law may be illegal, should cease immediately and should be fully investigated by Congress," said Sen. Lamar Alexander, R-Tenn., the senior Republican on the Senate health committee.
Alexander compared Sebelius' efforts to the Iran-Contra scandal of the 1980s when the Reagan administration went around Congress to raise funds for rebels in Nicaragua.
Previous administrations have taken steps similar to what Sebelius has done. President George W. Bush's administration, for example, worked closely with pharmacies, insurers, drug companies and consumer advocates to educate seniors before the 2006 implementation of the new Medicare Part D drug benefit. Much of that work was paid for directly by health care companies.
White House spokesman Eric Schultz, citing the precedents, accused Republicans of "re-fighting old political battles in an effort to dismantle the law." He said no one at the White House has participated in the effort to raise money for implementation of the law.
Enroll America, created by Families USA Executive Director Ron Pollack, a leading consumer advocate, has become a leading partner in the effort to get people to sign up for benefits. The relationship between the administration and Enroll America was strengthened last year when Anne Filipic, a former White House official, took over the organization.
The group, which raised nearly $5 million in 2010 and 2011, according to tax returns, brought together major health companies, including Aetna, CVS Caremark, Teva Pharmaceuticals and Express Scripts, with medical groups such as the American Academy of Pediatrics and consumer advocates such as the AARP and the American Cancer Society Cancer Action Network.
Enroll America's board of directors includes representatives of two insurance companies – Kaiser Permanente and Blue Shield of California.
"What we are doing is building a coalition and mounting a campaign to get the word out," Filipic said in an interview. "This is an effort where it is incredibly important that the private, public and the nonprofit sectors are coming together."
Filipic said Enroll America works closely with the Department of Health and Human Services but also with other groups. "Every day we are talking with partners," she said. "That is really what is needed with something of this scale."
Filipic would not discuss any fundraising that Sebelius has done for the effort, referring those questions to the agency.
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