All Eyes on HealthCare.gov Chief as New Enrollment Season Nears [WSJ]

November 7, 2014

Kevin Counihan Knows He Has One of Toughest Jobs in Washington; He Aims for Well-Running Ford Rather Than Flashy Maserati | Wall Street Journal

Kevin Counihan has one of the least enviable jobs in Washington.

As chief executive of HealthCare.gov, Mr. Counihan is responsible for making sure the site doesn’t falter during the second year of insurance sign-ups under the Affordable Care Act. Its disastrous launch last year embarrassed the Obama administration and frustrated millions who visited the portal to buy health plans.

Much is riding on this enrollment season, which begins Nov. 15. Polls show most Americans hold an unfavorable view of the law despite the fact that millions gained benefits from it this year. HealthCare.gov may have to withstand almost twice as many users as last year. Back-end parts of the site still remain unbuilt, though they aren’t immediately crucial for consumers.

President Barack Obama noted at a news conference Wednesday that the site’s “screw-ups” last year may have deterred some people from enrolling. “We’re really making sure the website works super well before the next open enrollment period,” he said. “We’re double and triple checking it.”

The Obama administration hopes Mr. Counihan can draw on his success running Connecticut’s well-oiled insurance exchange to reboot the health law. His start in September was part of a broader administration strategy to tap managers with operational experience—instead of policy or political backgrounds—after fumbles by last year’s enrollment officials.

“They needed a quarterback” for the site, and Mr. Counihan is the right person for that role, said Karen Ignagni, president of America’s Health Insurance Plans, the industry trade group.

The new management team at the Department of Health and Human Services, led by Secretary Sylvia Mathews Burwell, is avoiding gushing guarantees about the site’s performance. Behind the scenes, it is rigorously testing HealthCare.gov to make sure the basics work before tackling more ambitious tasks, such as moving the site to a new web host.

“Will we be perfect? No,” Mr. Counihan, 60 years old, said in a recent interview. “Everyone has to take a deep breath, chill and relax.” His aim for the site, he says, is to deliver a well-running Ford rather than a flashy Maserati.

As many as five million people could return and make changes to their coverage on HealthCare.gov for 2015, and millions more are expected to sign up for the first time. The morning it reopens, Mr. Counihan plans to be at a federal technology operation center in Bethesda, Md., watching display monitors as people enroll.

On the line for Mr. Counihan is a résumé that includes marketing the first health exchange for Massachusetts under the state’s health-care law, and later running the Connecticut insurance exchange. He also served as a top executive at a Massachusetts insurance plan and worked in marketing at the large carrier Cigna Corp.

Critics of Mr. Counihan say he has stumbled in the past and hasn’t always been forthright.

“He didn’t do a good job of informing us,” said state Sen. Kevin Kelly, the top Republican on the Connecticut general assembly’s insurance committee.

Mr. Kelly cited two instances where he and other lawmakers asked Mr. Counihan about flaws in the state-run site that caused it to display incorrect insurance-pricing information to thousands of users and put thousands more at risk of losing their plans altogether. Mr. Kelly said Mr. Counihan initially denied there was a problem and only acknowledged it after it was fixed.

Mr. Counihan said Mr. Kelly may have misunderstood him and that he didn’t have advance knowledge that he had kept from lawmakers. He said there were several examples in Connecticut where he was transparent about problems as soon as they emerged, including a data breach when a backpack containing personal information about individuals was found in the street.

Victoria Veltri, who serves as Connecticut’s official state health-care advocate, said Mr. Counihan was dedicated to helping consumers who ran into problems with the state site, and the two of them often stayed up late figuring out how to do it. “We talked nearly every night, late at night often after midnight, since we both seemed to work around the clock,” said Ms. Veltri. They also commiserated about the pressures of the work.

Mr. Counihan’s decision to take the HealthCare.gov job got a lukewarm response from his wife, Maryanne Hertel, a veterinary nurse, because she knew the intensity the job would require. She told him she thought Connecticut was supposed to be the last exchange he attempted, he said.

She has since come around. The couple—along with their standard poodle Derek—recently began relocating from Connecticut to what Mr. Counihan described as a Hobbit-sized rental in D.C.’s Georgetown neighborhood.

In Washington, Mr. Counihan is on the way to work before 8 a.m., coffee in hand on the metro, perusing briefing papers and power point presentations. Twice a day he attends a meeting called a daily standup to hear how the system is working. It takes place even on weekends. By 6 p.m., the meetings peter out and Mr. Counihan answers emails and takes time to plan.

Long after nightfall, he returns to his temporary digs at a motel with Chinese takeout or pizza. He has little downtime for his other passions, including performing in a rock band called “The Bleeding Hearts” that he says plays mostly “lefty benefits” covering 1980s hits.

Since his arrival in Washington, Mr. Counihan has taken a long view, including tasking a team with getting ready for 2016, said Andy Slavitt, principal deputy administrator at the Centers for Medicare and Medicaid Services.

As the first CEO of HealthCare.gov, Mr. Counihan has more power than five predecessors charged with running the site, an expanded authority designed to break down the divisions that led to problems last year. If the site doesn’t work smoothly, lawmakers will search for someone to answer the tough questions. “That person is Kevin,” Mr. Slavitt said.

Mr. Counihan said he understood that when accepting the position. “My job is to make it work, and that’s exactly what I plan on doing.”