Sebelius forced to get creative

The Obama administration, not surprisingly, would like additional resources from Congress to help in implementing the Affordable Care Act. Congressional Republicans, not surprisingly, are refusing to accommodate the requests because they hope to sabotage the entirety of the health care law and see the rejection of implementation funds as key to their efforts.

As a consequence, as Sarah Kliff reported on Friday, Health and Human Services Secretary Kathleen Sebelius has been forced to get creative, going to private-sector health executives and non-profit organizations, asking for financial support. Specifically, HHS hopes to raise funds from stakeholders for groups that are already working to enroll uninsured Americans and increase awareness of the law.

It’s a sensible goal — without greater public awareness, not only will Americans lack access to benefits they’re entitled to, but the law itself depends on greater participation to help keep costs down. It appears Sen. Lamar Alexander (R-Tenn.) doesn’t quite see it that way.

Alexander compared the fundraising to the Iran-Contra scandal. “Secretary Sebelius’s 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,” Alexander said in a statement. […]

“If the Department of Health and Human Services closely coordinates with Enroll America and with other such entities, then the legal analogy with Iran-Contra is strong,” Alexander said.

Um, no.

In the Iran-Contra scandal, the Reagan administration illegally sold weapons to a sworn enemy of the United States, in order to acquire funds to finance an illegal war in Nicaragua. Much of Reagan’s national security team, including his Secretary of Defense, was indicted, and it was a minor miracle Reagan himself wasn’t impeached.

In the contemporary case, the HHS secretary hopes to find outside resources to implement the health care law — a law that was approved by Congress and cleared by the Supreme Court. Circumventing and implementing federal law are not the same thing.

That said, HHS does have some legal lines to be aware of.

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A cabinet secretary is limited in the kind of fundraising he or she can do, and cabinet members cannot use their office to pressure donors for financial support, especially if the prospective donors have business in front of their department or agency.

Sebilius cannot, for example, call up a hospital executive and say, “It looks like you’ve applied for a contract with HHS. This seems like a good time, then, to mention a contribution I’ve been meaning to ask you for….”

But that doesn’t appear to resemble what’s happened at all. For one thing, there’s no evidence of quid pro quo. For another, Sebilius isn’t raising money for herself or for some political campaign; she’s seeking support from those who want to help, but aren’t regulated by HHS.

The Health and Human Services Department (HHS) says there’s nothing illegal or improper about soliciting donations to help promote President Obama’s healthcare law…. HHS spokesman Jason Young said the fundraising push serves the department’s basic goals.

“Part of our mission is to help uninsured Americans take advantage of new affordable, high quality insurance options that are coming, thanks to the health law,” he said. “For the last several months the Secretary has been working with a full range of stakeholders who share in the mission of getting Americans the help they need and deserve.”

Young said Sebelius has not made any fundraising requests to “entities regulated by HHS.” … “We have always worked with outside groups, and the efforts now ramping up are just one more part of that work,” Young said.

To see Iran-Contra in this is to look at reality through a fun-house mirror.

For what it’s worth, Sebilius has had some success — the Robert Wood Johnson Foundation is expected to contribute as much as $10 million, while H&R Block is expected to make a smaller donation of about $500,000.