# HHS to health insurers: "You might want to consider a voluntary contribution ..." **URL:** \ **Category:** Great Debates\ **Created:** [May 13, 2013, 2:39pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232 "2013-05-13T14:39:04Z")\ **Posts on this page:** 11\ **Page:** 1
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [May 13, 2013, 2:39pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/1 "2013-05-13T14:39:04Z")
From the [Wahington Post](http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/10/budget-request-denied-sebelius-turns-to-health-executives-to-finance-obamacare/): > [@](#): > > Health and Human Services Secretary Kathleen Sebelius has gone, hat in hand, to health industry officials, asking them to make large financial donations to help with the effort to implement President Obama’s landmark health-care law, two people familiar with the outreach said. > > Her unusual fundraising push comes after Congress repeatedly rejected the Obama administration’s requests for additional funds to set up the Affordable Care Act, leaving HHS to implement the president’s signature legislative accomplishment on what officials have described as a shoestring budget. > [@](#): > > [HHS spokesman Jason] Young said that Sebelius did not solicit for funds directly from industries that HHS regulates, such as insurance companies and hospitals, but rather asked them to contribute in whatever way they can. > > But the industry official who had knowledge of the calls but did not participate directly in them said there was a clear insinuation by the administration that the insurers should give financially to the nonprofits. > > Meredith McGehee, policy director for the nonpartisan Campaign Legal Center, which researches government ethics issues, said she was troubled by Sebelius’s activities because the secretary seemed to be “using the power of government to compel giving or insinuate that giving is going to be looked at favorably by the government.” You can understand where Sebelius is coming from. She is between a rock and a hard place in that Republicans are simultaneously defunding administration of the program and criticizing it as a train wreck, and she is hard pressed to do something to avert an implementation disaster. Nonetheless, no suggestion from a government official who has enormous influence over your business is really a suggestion, and no such contribution would be truly voluntary. You read about Vladimir Putin and others of this sort doing this sort of thing. I find it troubling to see it happening here. ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [May 13, 2013, 2:46pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/2 "2013-05-13T14:46:47Z")
I agree it is troubling, if true. My hope is that there is a significant misunderstanding. One would think that, if it is true, named on-the-record sources will come out soon. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [May 13, 2013, 2:51pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/3 "2013-05-13T14:51:21Z")
Possible. But I don’t know. The same reason the health insurance people would be pressured to contribute is the same reason they might be reluctant to speak up on the record. Not much in it for them. They are not polical ideologues. Their purpose is to do the best job for their company. Publically crossing the head(s) of the HHS would be very much against their interests. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [May 13, 2013, 3:05pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/4 "2013-05-13T15:05:36Z")
> [@Fotheringay-Phipps](#): > > You can understand where Sebelius is coming from. She is between a rock and a hard place in that Republicans are simultaneously defunding administration of the program and criticizing it as a train wreck, and she is hard pressed to do something to avert an implementation disaster. Are Republicans defunding administration of the program? I read Republicans refused to increase funding for implementation and, of course, many states are refusing to set up their own exchanges. This is not the same as Republicans defunding it though. Do you have a cite for that? ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [May 13, 2013, 3:06pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/5 "2013-05-13T15:06:35Z")
> [@Jas09](#): > > I agree it is troubling, if true. My hope is that there is a significant misunderstanding. One would think that, if it is true, named on-the-record sources will come out soon. Which is troubling you more-the fact that they are asking for donations, or the fact that Republicans have forced them to do so? ---
**Author:** ![Buck\_Godot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/buck_godot/32/6573_2.png) [@Buck\_Godot](https://boards.straightdope.com/u/Buck_Godot)\ **Post date:** [May 13, 2013, 4:23pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/6 "2013-05-13T16:23:12Z")
I’m not sure how big a scandal this is? If the government asks the Catholic church to help them set up a food bank, is that seen as strong arming the Church? ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [May 13, 2013, 4:38pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/7 "2013-05-13T16:38:14Z")
> [@Buck\_Godot](#): > > I’m not sure how big a scandal this is? If the government asks the Catholic church to help them set up a food bank, is that seen as strong arming the Church? I’m just speculating but, since government regulates the insurers, it could be seen as strong arming the sector for donations. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [May 13, 2013, 4:59pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/8 "2013-05-13T16:59:17Z")
> [@yorick73](#): > > Are Republicans defunding administration of the program? I read Republicans refused to increase funding for implementation and, of course, many states are refusing to set up their own exchanges. This is not the same as Republicans defunding it though. Do you have a cite for that? I don’t know. I didn’t mean defunding in the sense of removing funding that was already allocated. I meant depriving it of enough funding to function efficiently (and then complaining that it was a mess). > [@yorick73](#): > > I’m just speculating but, since government regulates the insurers, it could be seen as strong arming the sector for donations. Exactly. Most insurance regulation is actually at the state level, but the HHS has an influence, and this has increased significantly under the ACA. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [May 13, 2013, 5:26pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/9 "2013-05-13T17:26:14Z")
From a practical point of view, there’s some merit to Sebelius’ suggestion (or threat, or whatever it was.) The insurers and administrators that get in first in the exchange system are going to be miles ahead of everyone else in terms of saving administrative costs and the like. Assuming she said what she is accused of saying, though (“industry official who had knowledge of the calls but did not participate directly in them” could just as easily be “crank who happens to work in insurance” as “concerned insider”), she did a Bad Thing. I’m sure a polite request for donations from the DHHS is at least as coercive as a polite United Way donation request from one’s employer. Having said all that, the implementation budget is what it is. If that means doing a shitty job, so be it. ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [May 13, 2013, 5:34pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/10 "2013-05-13T17:34:26Z")
> [@Really\_Not\_All\_That\_Bright](#): > > From a practical point of view, there’s some merit to Sebelius’ suggestion (or threat, or whatever it was.) The insurers and administrators that get in first in the exchange system are going to be miles ahead of everyone else in terms of saving administrative costs and the like. > > Assuming she said what she is accused of saying, though (“industry official who had knowledge of the calls but did not participate directly in them” could just as easily be “crank who happens to work in insurance” as “concerned insider”), she did a Bad Thing. I’m sure a polite request for donations from the DHHS is at least as coercive as a polite United Way donation request from one’s employer. > > Having said all that, the implementation budget is what it is. If that means doing a shitty job, so be it. Bingo, why did the implementation budget suddenly change? It doesn’t exactly give a warm fuzzy about the so called “revenue-neutral” ness of the entire package… Of course for everyone who spoke out against the actual costs, this is news to none of them. ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [May 13, 2013, 5:40pm UTC](https://boards.straightdope.com/t/hhs-to-health-insurers-you-might-want-to-consider-a-voluntary-contribution/658232/11 "2013-05-13T17:40:45Z")
> [@Czarcasm](#): > > Which is troubling you more-the fact that they are asking for donations, or the fact that Republicans have forced them to do so? Well, its a bit unclear how much of this is forced and how much is inadequate implementation budget. Obviously GOP obstruction has taken what was always going to be a difficult-to-implement plan and made it nearly unworkable. So I definitely understand the difficulty of the situation. Personally, my hope is that the states that implement the exchanges correctly will see large competitive advantages compared to those that don’t. I could even see workable state-wide individual exchanges replacing employer-sponsered plans in some states, which could be a big boost to industries based in those states. Not to mention any public-health benefits that accrue. In the end, I think that good-governance will win out over obstruction.