Health and Human Services Secretary Kathleen Sebelius and other department staff may be continuing to solicit private donations to help an outside group promote the president's health care law as the administration works to boost enrollment figures after a troubled fall rollout.
News last May that Sebelius had asked business executives and nonprofit groups to donate to Enroll America, a nonprofit organization formed to help encourage millions of Americans to sign up for the new Obamacare insurance exchanges, provoked an uproar among Republicans on Capitol Hill.
Two GOP-led House committees launched investigations, and several Republican senators called on the Health and Human Services inspector general to investigate Sebelius' fundraising drive, which watchdogs have described as an unethical shakedown for cash.
Eight months after the news broke, Sebelius' spokeswoman last Friday sidestepped questions from the Washington Examiner on whether her boss has continued to solicit funds from outside groups for Enroll America's efforts.
“The secretary has engaged in a sustained, aggressive outreach campaign to reach as many Americans as possible during open enrollment,” HHS spokeswoman Joanne Peters said in an emailed statement Friday afternoon.
“We're [sic] have been working closely with a range of partners groups across the country to reach the uninsured, and to help get them enrolled in quality, affordable health insurance,” Peters continued.
She did not respond to a follow-up question specifically asking whether Sebelius has continued the fundraising.
Peters made the statement in response to several questions the Washington Examiner posed about the details of emails between Enroll America officials and Health and Human Services aides, including some with staffers from the White House Office of Public Engagement.
The emails, which the Washington Examiner obtained through a Freedom of Information Act request, reveal a close working relationship between top HHS aides, Sebelius, Enroll America and former White House aides on their fundraising efforts.
The Examiner asked whether Sebelius believed the close working relationship is appropriate and whether Sebelius has continued fundraising for Enroll America since news first broke about the solicitations last May.
In addition to weekly conference calls between Enroll America staffers and key HHS aides, the emails show the nonprofit's efforts to urge HHS aides and Sebelius herself to solicit funds on its behalf.
In one Feb. 26, 2013, email with the subject line “Re: H/R block,” Enroll America President Anne Filipic wrote to Anton Gunn, the former head of HHS's Office of External Affairs, and Sol Ross, the director of business outreach in the department's Intergovernmental and External Affairs Office.
She mentioned a meeting Sebelius had with H&R Block executives ahead of their own meeting scheduled for that day and said she wanted to put the matter “at the top of your inbox” to make sure “we're all on the same page in terms of the asks we will make of them.”
“We are meeting with H&R Block tomorrow and are eager to touch base in advance of that,” Filipic wrote. “I know the secretary met with them yesterday and just want to be sure we're all on the same page in terms of the asks we will make of them.”
Filipic worked for President Barack Obama as deputy director of White House public engagement before helping create Enroll America.
In another email between Filipic and Gunn with the subject “H&R,” Filipic asked whether a call from “KGS is in the works” and urges HHS action to get “that number up” — an apparent reference to a fundraising goal.
“Hey Anton — Martine mentioned that you all have a conversation with Theresa and the H&R team scheduled for today. We're trying to figure out next steps here (really need to get back to them this week) and are wondering if a call from KGS is in the works. Could you share your thoughts after you talk with Theresa?” Filipic wrote.
“We'd really love the help getting that number up but don't want to miss the opportunity here, and they've made clear they are on a quick timeline. I'll be eager for your thoughts!” she concluded.
The Washington Examiner made the FOIA request last June for “any and all [HHS] emails containing the term Enroll America.” The HHS FOIA office partially responded to the request Jan. 30.
The FOIA office located 448 pages of emails and documents shared between Enroll America and HHS, and released 257 pages of them. The office delayed release of another 179 pages of “responsive records” it said were “under review for consultation” and could not provide an estimate for how long the review would take.
In addition, the FOIA office redacted portions of the emails they provided, along with 12 pages in their entirety under an exemption that permits the withholding of records which are “deliberative in nature and per-decisional and contains staff advice, opinion and recommendation.”
The exemption is intended to preserve free and candid internal dialogue leading to decision-making, the office said.
A May 10 Washington Post article said Sebelius had contacted several private entities, including some in the health care industry, and asked them to contribute to Enroll America, which is made up of Obama campaign loyalists and former White House staffers.
The article quoted Ellen Murray, assistant secretary for financial resources at HHS, saying that the fundraising was an effort to “come up with a Plan B” once Congress denied funding to promote the Affordable Care Act's fall enrollment drive.
Under fire for the fundraising, a month later, Sebelius told the House Education and Workforce Committee that she has directly solicited two groups HHS does not regulate — the Robert Wood Johnson Foundation and H&R Block. She also said she called three other groups HHS regulates but asked them only for support and didn't request a donation: Kaiser Permanente, Johnson & Johnson, and Ascension Health.
The Robert Wood Johnson Foundation, a nonprofit that supports anti-obesity and other health outreach campaigns, last year said it had contributed $14 million to Enroll America. It owns more than $1 billion worth of stock in Johnson & Johnson, which HHS regulates. The Food and Drug Administration, which is part of HHS, regulates Johnson & Johnson's drugs and medical devices.
H&R Block last year said it has doled out $500,000 to the group. As the country's largest tax services provider, the company stands to reap a windfall from new business in advising Americans whether they qualify for Obamacare tax credits or must pay a penalty for failing to buy insurance.
Kaiser Permanente, which has representatives on Enroll America's board, also has donated. As of November of last year, Enroll America officials said the group has raised $27 million so far from entities that include the Ford Foundation, the California Endowment, the Kate B. Reynolds Charitable Trust, Saint Luke's Health Initiatives, the Tennessee Hospital Association and Catholic Health Initiatives.
Sen. Lamar Alexander, a Republican from Tennessee and the ranking member of the Senate committee that oversees health policy, has argued that Sebelius' efforts are illegal because Congress has specifically denied funds for the Affordable Care Act's implementation and compared her fundraising to the Iran-Contra scandal.
Alexander and other Republicans in Congress have asked the Government Accountability Office, the investigative arm of Congress, and the HHS inspector general to look into the extent Sebelius and her staff are coordinating with Enroll America and other organizations.
Republicans say the Sebelius fundraising drive violates the federal Anti-Deficiency Act, which prohibits government agencies from accepting voluntary services or donations. But HHS officials contend that a section of the Public Service Act specifically permits the secretary to ask outside companies and entities to write checks to support health programs.
That act does not allow the White House to engage in the same type of solicitation of private entities, and White House officials have said they did not sign off on the fundraising although they were generally aware of the outreach plans.
Sebelius and House Democrats argue that engaging public-private partnerships to help promote the law is similar to what President George W. Bush's administration did to promote the prescription drug benefit in Medicare Part D expansion and the Children's Health Insurance Program.
Watchdog and good-government groups disagree over whether Sebelius violated federal laws with the fundraising, but they all say asking private companies to financially support Obamacare's rollout raises serious ethical questions.
“Obviously, there’s an appearance problem,” said Melanie Sloan, the executive director of Citizens for Responsibility and Ethics in Washington. “If she was soliciting for a Girl Scout troop in her neighborhood — something totally unrelated to health care — I don’t think you would have these questions, but she is charged with implementing the most significant health care changes in a generation.”