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Obamacare in the Blue States

The great coverup.

Jun 9, 2014, Vol. 19, No. 37 • By MICHAEL ASTRUE
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The self-declared consumer watchdogs of the Massachusetts congressional delegation and state attorney general Martha Coakley have been studiously silent about evidence of possible criminal activity in Massachusetts, which includes untrue statements made to obtain funding as well as multiple cases of no-bid contracts going to entities paid to oversee themselves. They need to raise their voices to ensure that federal and state law enforcement officials step in immediately. 

Patrick’s pattern of behavior has an increasingly Nixonian flavor, thus it is overdue to ask, “What did he know and when did he know it?” His stonewalling of financial data that other states have disclosed is the first indicator of a problem. The second sign is that there is simply no credible explanation—other than outright misrepresentation—for how Massachusetts slipped through the CMS gate reviews without having even a marginally functional beta version of its exchange. Tellingly, members of the state oversight board for the Massachusetts exchange have complained about their own staff’s failure to inform them promptly that the system had failed. Minutes of advisory board meetings on the exchange’s website document this failure. 

The third, and perhaps the most critical, sign of misconduct is that Patrick has stripped the executive director of the state exchange of her program management and contracting responsibilities. He has placed functional control of the state’s exchange in the hands of his trusted former deputy chief of staff for cabinet affairs, a labor lawyer who is totally lacking in the technical expertise or experience necessary to turn around the failed exchange. Desperate damage control is trumping transparency and competence. 

The collapse of the Minnesota’s MNsure website mirrors the Massachusetts meltdown. Again, an arrogant and inexperienced executive director withheld critically important information from her board, the public, and even the insurance companies that needed to plug into the system. Again, ill-advised software contracts compounded timeline failures produced primarily by poor planning and execution. Somehow, Minnesota also miraculously passed the CMS gate reviews even though, as in Massachusetts, it could not test a beta system before its failed launch. We need to know how CMS could have possibly found adequate progress for functionality and security in light of this disarray, and law enforcement needs to know too.

President Obama is setting up his new HHS secretary for failure if he hesitates to hold his appointees accountable. As the VA scandals demonstrate, we cannot rely on investigations by an inspector general who has been a significant and longstanding part of the problem he is investigating. President Obama should fire Inspector General Levinson, and he should do so immediately. Next, he should direct Attorney General Holder to appoint a special counsel with broad powers to oversee an investigation into all the failed state exchanges in order to determine whether federal and state officials committed felonies. Finally, Congress needs to ask whether partisan considerations—or personal relationships such as the friendship between President Obama and Governor Patrick—influenced decisions by CMS officials to continue funding completely nonfunctional systems.

As a student of American history and a scholar of constitutional law, President Obama should be well aware of how hesitation in the coming weeks could taint his legacy.

Michael Astrue is a former commissioner of Social Security and general counsel of the U.S. Department of Health and Human Services.

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