Obama taps national security veteran to oversee HealthCare.gov

The lack of a financial management system for HealthCare.gov continues to trouble oversight agencies and insurance carriers.

Kristie Canegallo, second from right in an April 1 photo op with President Barack Obama, will supervise management of HealthCare.gov and other efforts to implement the 2010 health care law.

President Barack Obama tapped Kristie Canegallo, an adviser to White House chief of staff Denis McDonough, to supervise management of the HealthCare.gov website, overall implementation of the 2010 health care law and efforts to reform how the federal government procures technology.

In addition, Canegallo's broad portfolio includes expanding Internet access in public schools and supervising the continued drawdown of American military involvement in Afghanistan. She will serve as deputy chief of staff and fill the executive oversight role on HealthCare.gov currently occupied by Phil Schiliro, who is stepping down.

"The president has directed that whenever we go through a major event, we capture the lessons learned so that we don't repeat them, and [so] that we adapt," McDonough said in a statement. "Given our experience with HealthCare.gov, we have determined we need more senior-level focus on implementation and execution."

Canegallo has guided the White House's coordination of efforts to repair HealthCare.gov after its balky launch last October, according to an article in Politico. She served as a director in the National Security Council's Defense Policy and Strategy Directorate for two years before becoming senior adviser to McDonough.

Despite the Obama administration's victory lap after enrollments through HealthCare.gov and state-based insurance marketplaces topped 8 million, more work needs to be done on the back end of the system that calculates subsidies and makes payments to insurance carriers.

Because the work of reconciling subsidies -- which involves matching insurance applications with supporting financial documents such as paystubs and tax returns -- is being done manually, there is the potential for error and for long lags in confirming subsidy payments. Officials at the White House and the Centers for Medicare and Medicaid Services have been prodding Serco, the contractor charged with processing the paper applications, to speed up its work, according to a recent article in the Washington Post.

These aren't just a small number of outlying cases, according to the Post. Inconsistencies exist in about 3 million of the 5.5 million applications from people who signed up for insurance through the HealthCare.gov marketplace, and more than 1 million enrollees might be receiving the wrong level of subsidy. Many of the inconsistencies have to do with proof of eligibility and income.

CMS spokeswoman Julie Bataille told the Post that "an inconsistency does not mean there is a problem with a consumer's enrollment." However, when an inconsistency is flagged, enrollees are required to submit documentation that the government is supposed to review within 90 days.

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