Counihan will be in place for the second year of enrollment, which starts Nov. 15, for the website that famously ground to a near halt shortly after going online. The federal government’s HealthCare.gov now serves the 36 states that didn't create their own exchanges, where consumers without affordable employer coverage or a public plan can purchase health insurance online, often with the help of government subsidies.
Counihan's new job won’t be easy. State exchanges have to link to various federal agencies for tasks like income verification, but the federal marketplace is both larger and more complex. By comparison, the federal exchange signed up 5.4 million people to the 2.6 million in state-based exchanges. He'll be the first ever CEO of the federal exchange, a position many called for after the disasterous rollout of the marketplace; HHS has yet to fill a new, seperate technology chief job.
While federal officials were able to stabilize HealthCare.gov by late last year and enrollment subsequently surged, they’ve also acknowledged in recent Congressional hearings that technical problems will persist in year two. Industry groups such as America’s Health Insurance Plans have also complained that online payment systems still don't work.
But Counihan ran a state exchange that observers praised for its functionality. That was in part because the state purposefully trimmed down the number of tasks it would perform initially. Jim Wadleigh, the Connecticut exchange’s chief information officer, previously told Governing that the state left plan management and some reporting features for later. Connecticut’s site initially offered six functions to the federal government’s roughly 14, excluding things like the collection of premiums, which insurers took on directly in the state.
The software platform used by Connecticut’s exchange also worked well, drawing inquiries from nine states interested in adopting it, according to the Centers for Medicare and Medicaid Services, the HHS department that oversees health exchanges. While CMS said Connecticut was the first state in the country to exceed its enrollment target of 100,000, the state also included new Medicaid enrollees when it announced it had reached 120,000 sign-ups in February. Republican opponents in the state pointed out that enrollment in private plans actually fell short.
Running an exchange also includes marketing and publicity, another area where Connecticut developed a reputation as a leader, creating storefront locations and taking its message to events such as a Lil’ Wayne concert.
Counihan comes to CMS after decades in health care. Past expierence includes private-sector work with giants like Cigna and helping to launch Massachusetts’ health exchange in 2006.
