U.S. Department of Health and Human Services

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Department of Health and Human Services
US-DeptOfHHS-Logo.svg
Secretary:Sylvia Mathews Burwell
Deputy Secretary:Bill Corr
Annual budget:$907.7 billion (2013)
Total employed:64,750 (2013)
Year created:1979
Official website:http://www.hhs.gov/

FederalAffairsLogo-01.png

Executive Departments of the United States

Executive Departments
Department of DefenseDepartment of StateDepartment of Homeland SecurityDepartment of JusticeDepartment of CommerceDepartment of EducationDepartment of the TreasuryDepartment of AgricultureDepartment of EnergyDepartment of LaborDepartment of TransportationDepartment of the InteriorDepartment of Health and Human ServicesDepartment of Veterans AffairsDepartment of Housing and Urban Development

Department Secretaries
Chuck HagelJohn KerryJeh JohnsonEric HolderPenny PritzkerArne DuncanJack LewTom VilsackErnest MonizTom PerezAnthony FoxxSally JewellSylvia Mathews BurwellRobert McDonaldJulian Castro
The Department of Health and Human Services is a United States executive department established in 1979. The department was formed for "protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves."[1][2] The previous department secretary, Kathleen Sebelius, resigned from her post on April 10, 2014, following the troubled rollout of Healthcare.gov. Sylvia Mathews Burwell is the current Secretary of Health and Human Services.[3]

The department employs 64,750 employees.[4] The operating budget for fiscal year 2013 was $907.7 billion.[5] The department oversees agencies including, the Centers for Medicare and Medicaid Services (CMS), the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).

History

The department was formed as the cabinet-level Department of Health, Education and Welfare (HEW) in 1953 under President Eisenhower. In 1979 the Department of Education split from HEW, and the Department of Health and Human Services was formed. Below is a list of events throughout the department's history:[1]

  • 1953: Salk polio vaccine licensed
  • 1964: First Surgeon General's report on smoking and health
  • 1965: Medicare and Medicaid programs created
  • 1979: Department of Health and Human Services and Department of Education split from (HEW)
  • 1984: National Organ Transplantation Act became law
  • 1990: Human Genome Project established
  • 1996: Health Insurance Portability and Accountability Act (HIPAA) became law
  • 1997: State Children's Health Insurance Program (SCHIP) created
  • 1999: Anti-bioterrorism initiative launched
  • 2003: Medicare Prescription Drug Improvement and Modernization Act enacted
  • 2010: Affordable Care Act (ACA) became law

Structure

Mission

The U.S. Department of Health and Human Services building

The Department of Health and Human Services website states the mission:[2]

The mission of the Department of Health and Human Services is to help provide the building blocks that Americans need to live healthy, successful lives.[6]

Leadership

Sylvia Mathews Burwell is the current Secretary of Health and Human Services.[3]

The Secretary of Health and Human Services advises the President on "health, welfare, and income security plans, policies, and programs of the Federal Government."[7] The duties of the Secretary of Health and Human Services include:

  • Oversees a budget of over $900 billion and approximately 65,000 employees
  • Directs Department staff in carrying out the approved programs and activities of the Department and promotes general public understanding of the Department's goals, programs and objectives
  • Administers these functions through 12 operating agencies. These agencies include the Food and Drug Administration (FDA), Center for Disease Control (CDC), National Institutes of Health (NIH) and Centers for Medicare & Medicaid Services (CMS).[7]

Note: Votes marked "N/A" represent voice votes or unrecorded votes.


Organizational chart

HHS org chart.jpg

Obama administration

Issues

Affordable Care Act

See also: Obamacare overview
President Barack Obama

The Patient Protection and Affordable Care Act, commonly known as Obamacare, was passed in its finality on March 21, 2010, and signed into law by President Obama on March 23, 2010.[8]

The aim of the law was to provide an expansion of health insurance coverage to more Americans through both individual health insurance marketplaces as well as through employer-provided plans. Minimum requirements of coverage were established and both individual and employer mandates were established over a period of years in order to achieve the goal of expanded coverage. Subsidies and tax credits are provided to individual consumers based on income level and dependents, and existing programs such as medicaid and CHIP were expanded to increase reach. Small businesses receive tax credits based on the level of insurance offered to employees, as well.[9]

Ten essential benefits for coverage

The law included ten essential benefits that plans created after the law's passage needed to include. Existing plans were grandfathered in, but few of the grandfathered plans remain due to frequent changes to health insurance policies.[10] The ten essential benefits outlined by the ACA are:[11]

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance abuse disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care
Rite Aid partnership

On September 9, 2013, Sebelius announced a partnership with Rite Aid to promote the Affordable Care Act throughout the country. The company promised to place insurance agents at 2,000 of the chain's 4,600 locations nationwide. Agents were not to be affiliated with the insurers offering new exchanges, but they did receive commission on each policy taken out. Rite Aid also received a commission per policy. Sebelius commented on the agreement, stating, "We weren't ever going to make this program work from Washington. This has to be an on-the-ground effort. Americans trust their pharmacists. Often the pharmacist is the on-the-ground health provider people see the most and know the best, so having this critical role in a pharmacy makes wonderful sense."

Steve Lonegan, a New Jersey candidate for U.S. Senate, spoke out against the agreement, stating, "If Rite Aid and the other big companies are so enthusiastic and think this is such a great plan, let it stand on its own two feet."[12]

Enrollment

On August 8, 2014, the U.S. Department of Health and Human Services (HHS) announced that more than seven million Americans have gained health coverage since enrollment in Obamacare began October 1, 2013. The 7.2 million new participants have enrolled in Medicaid and the Children's Health Insurance Program (CHIP). The new participates include uninsured Americans that gained coverage through traditional Medicaid, as well as Medicaid expansion passed in 26 states under the Affordable Care Act. Those states saw a 18.5 percent increase in enrollment, while non-expansion states saw only a 4 percent increase.[13][14]

On August 12, 2014, the Obama administration announced that over 300,000 people that gained coverage under the Affordable Care Act are in danger of losing their insurance next month if they do not prove that they are living in the U.S. legally. About 450,000 cases with discrepancies related to citizenship have been resolved, but about 310,000 people have not responded to calls, letter and emails asking about inconsistencies related to citizenship or immigration information on their application. In another round of letters sent by the administration, the administration has asked the enrollees to submit more documentation by September 5 or lose their coverage by September 30.[15]

Organ transplant lists

Former secretary Kathleen Sebelius

In late May 2013, Secretary of Health and Human Services Kathleen Sebelius was involved in debate over transplant lines for adult lungs. Policy requires that children under 12 in need of a lung transplant be placed at the bottom of the waiting list for adult lungs, while being placed at the top of the transplant list of childrens' lungs, though they are more rare. Ten year-old Sarah Murnaghan of Pennsylvania was in need of a lung transplant due to cystic fibrosis. She had been on the pediatric lung transplant list for 18 months. Sebelius ordered a review of the policy, but stated she "can't imagine anything worse than one individual getting to pick who lives and who dies."[16] On June 5, 2013, a federal judge ordered Sebelius to allow Murnaghan to be added to the adult lung transplant list, giving her a higher probability of receiving a transplant, after hearing oral arguments in a lawsuit filed by Murnaghan's parents. A change to the policy would allow about 20 children annually to be added to the adult waiting list consisting of 1,600 patients. Dr. Arthur Caplan of the New York University Langone Medical Center explained that the reasoning behind the policy is that children generally fair worse than adults after the procedure. Caplan worried that the precedent set by the court ruling could result in politicizing medical judgements.[17]

Controversies

Healthcare.gov rollout

See also: Healthcare.gov website rollout

Sen. Pat Roberts (R-KS) calls for Kathleen Sebelius' resignation.

The launch of the Healthcare.gov website featuring the federal healthcare exchanges created by the Affordable Care Act was met with error messages, faulty information being sent to insurers and problems with direct enrollment through insurance companies.[18][19][20] At an October 10, 2013, promotional event for the website, Sebelius stated, "Believe me, we had some early glitches, but it's getting better every day."[21] Sen. Pat Roberts called for Sebelius' resignation over the struggling website on October 11, stating, "Enough is enough. Today I am calling on Kathleen Sebelius to resign her post as Secretary of Health and Human Services. Secretary Sebelius has had three and a half years to launch Obamacare, and she has failed."[22] Sebelius testified before the House Energy and Commerce committee on October 30, 2013. During testimony, Sebelius stated: "In these early weeks, access to HealthCare.gov has been a miserably frustrating experience for way too many Americans, including many who have waited years, in some cases their entire lives, for the security of health insurance."[23][24] Officials have not released an estimated timeframe for fixes.[25]

On October 23, Rep. Jeanne Shaheen, (D-NH) called for an extension of the open enrollment period while the administration attempted to fix the problems, while Sen. Joe Manchin, (D-WV) was already drafting a bill to delay the individual mandate for a year.[26]

On April 10, 2014, Sebelius resigned as Secretary of HHS in part due to the troubled rollout of Healthcare.gov.[27]

Meetings with Barack Obama

The Government Accountability Institute found in December 2013, that between July 12, 2010, and November 30, 2013, President Obama's public schedule had no one-on-one meetings between Obama and Sebelius, who was in charge of implementing his "most important initiative." During that timeframe there were 277 meetings with other cabinet members. In response to the claim that the two had not met over that period of time, Press Secretary Jay Carney stated, "Cabinet secretaries don’t regularly get entered into the visitor logs."[28] A Department spokesperson backed up Carney's statements, claiming, "She is frequently at the White House for meetings related to the implementation of the Affordable Care Act, including dozens with the President in the last year alone. In fact, she met with the President just yesterday."[29]

The Hill released the findings of a Freedom of Information Act request on February 13, 2014, showing evidence of 18 meetings between October 2012 and October 2013. Seven of those meetings were specifically on the topic of Obamacare. When questioned by the news outlet on why President Obama was not aware of the website problems, an HHS Department spokesperson responded, "She is frequently at the White House for meetings on a wide range of topics, including the implementation of the Affordable Care Act. As we have also said, the Affordable Care Act is more than just a website, and consistent with other significant policy initiatives, there was coordination across the Administration on a broad range of policy and implementation topics."[30]

Contracting practices investigation

On December 11, 2013, Sebelius asked the inspector general of the Health and Human Services Department to open an investigation into the contracting practices involved in the Healthcare.gov website. She said the investigation's results would help to prevent future issues like happened with the website rollout. She also announced the creation of a chief risk officer position in the Centers for Medicare and Medicaid Services.[31]

Analysis

Budget

Obama administration

The following chart details the Department's budget throughout Barack Obama's presidency. On average, the budget has increased by 4.12 percent annually during Obama's tenure of office.

pChart

U.S. Department of Health and Human Services[32] Annual Budget
YearBudget (in billions)% Difference from previous year
2014$967.36.55%
2013$907.87.03%
2012$848.2-4.84%
2011$891.34.34%
2010$854.27.55%
2009$794.2N/A
  • Note: 2014 only represents the Department's budget request, not an enacted budget.

Employment

The Best Places to work in the Federal Government is a website that tracks workforce trends in federal agencies. According to their analysis, from 2005-2011, the Department of Health and Human Services added an average of 1,326 jobs per year.[4]

The 2013 Best Places to Work Index ranked the Department of Health and Human Services as 7th out of the 19 large agencies.[33]

The index score is calculated on three questions asked in the office of Personnel Management’s (OPM) Federal Employee Viewpoint Survey. The three questions are the following:

  • I recommend my organization as a good place to work. (Q. 40)
  • Considering everything, how satisfied are you with your job. (Q. 69)
  • Considering everything, how satisfied are you with your organization. (Q. 71)[34][6]

Recent news

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All stories may not be relevant to this page due to the nature of the search engine.

U.S. Department of Health and Human Services News Feed

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See also

External links

References

  1. 1.0 1.1 Department of Health and Human Services, "Historical Highlights," accessed December 9, 2013
  2. 2.0 2.1 HHS.gov, "About," accessed November 18, 2013
  3. 3.0 3.1 New York Times, "Health Secretary Resigns After Woes of HealthCare.gov," April 10, 2014
  4. 4.0 4.1 Best Places to Work in the Federal Government, "Health and Human Services Department," accessed December 10, 2013
  5. HHS.gov, "FY 2012 budget in brief," accessed November 18, 2013
  6. 6.0 6.1 Note: This text is quoted verbatim from the original source. Any inconsistencies are attributed to the original source.
  7. 7.0 7.1 HHS.gov, "Guide to Information Resources," accessed August 11, 2014
  8. New York Times, "Obama Signs Health Care Overhaul Bill, With a Flourish," March 23, 2010
  9. Kaiser Family Foundation, "Summary of the Affordable Care Act," March 12, 2014
  10. Washington Post, "This is why Obamacare is canceling some people's insurance plans," October 29, 2013
  11. National Association of Insurance Commissioners, "Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges," April 20, 2010
  12. ABC News, "Kathleen Sebelius launches ObamaCare effort with Rite Aid in New Jersey," September 9, 2013
  13. The Hill, "Medicaid enrollments top 7M under O-Care," August 8, 2014
  14. Reuters, "New U.S. Medicaid enrollments top 7 million under Obamacare," August 8, 2014
  15. NY Times, "Over 300,000 Must Prove Eligibility or Lose Health Care," August 12, 2014
  16. Politico, "Kathleen Sebelius at center of storm over child's lung transplant," June 4, 2013
  17. Fox News, "Dying girl intubated as she awaits lung transplant," June 10, 2013
  18. Chicago Tribune, "Computer glitches, overloads hit health care exchanges," October 1, 2013
  19. Bloomberg, "Insurers Getting Faulty Data From U.S. Health Exchanges," October 8, 2013
  20. Politico, "Another obstacle to signing up for ACA crops up," October 21, 2013
  21. Pittsburgh Tribune-Review, "Sebelius visit fails to reassure as health care website glitches persist," October 10, 2013
  22. Youtube, "Senator Roberts Call For Secretary Sebelius to Resign," October 11, 2013
  23. CNN, "Sebelius: 'I apologize, I'm accountable' for Obamacare website flaws," October 30, 2013
  24. Politico, "Kathleen Sebelius offers to testify on Obamacare," October 22, 2013
  25. Politico, "Tech 'surge' to tackle Obamacare websites," October 20, 2013
  26. NBC News, "Obama administration clarifies dates related to health care rollout," October 23, 2013
  27. New York Times, "Health Secretary Resigns After Woes of HealthCare.gov," April 10, 2014
  28. Politico, "When Barry Met Kathy," December 5, 2013
  29. Politico, "Jay Carney pushes back on Kathleen Sebelius report," December 6, 2013
  30. The Hill, "Before O-Care debacle, Sebelius made many trips to White House," February 13, 2014
  31. Wall Street Journal, "Sebelius Calls for Review of Healthcare.gov Contracting Practices," December 11, 2013
  32. U.S. Department of Health and Human Services, "Budget and Performance," accessed January 31, 2014
  33. Best Places to Work, "Best Places to Work Agency Index Scores," accessed August 11, 2014
  34. Best Places to Work, "Methodology," accessed August 11, 2014