U.S. Health and Human Services Secretary Sylvia Burwell named Optum executive Andy Slavitt, who led day-to-day operations to fix the faulty website, to a new No. 2 post at the Centers for Medicare and Medicaid Services (CMS), giving him authority for policy and operational coordination for the agency's initiatives.
In a long-anticipated response to some of Obama's top outside health advisers, she also announced the creation of a new chief executive position to oversee the federal government's private health insurance exchange, as well as a permanent marketplace chief technology officer.
"These actions will bolster our team and further instill ongoing accountability for reaching milestones, measuring results and delivering results for the American people," Burwell said in a statement that came two weeks after she was confirmed in her job by the U.S. Senate.
CMS, the Department of Health and Human Services (HHS) agency responsible for implementing Obama's healthcare reform law, has been widely blamed for missteps that led to last year's botched rollout of HealthCare.gov, the federal marketplace portal for millions of new health insurance policyholders in 36 states.
Outside experts blamed a lack of management oversight for the debacle, which pushed Obama's signature domestic policy achievement to the brink of failure before an emergency rescue operation salvaged the website from paralyzing technical problems, enabling millions of Americans to obtain subsidized private health coverage.
Burwell's creation of a marketplace CTO makes permanent the tech czar role that was filled temporarily by Obama adviser Jeffrey Zients and former Microsoft executive Kurt Delbene.
Some administration allies, including former Obama adviser Dr. Ezekiel Emanuel and the Center for American Progress (CAP) think tank, have seen the appointment of a new marketplace CEO as crucial to the long-term success of the policy.
"Under this structure, a single leader will be empowered and accountable for further implementation of the program, as well as able to provide a singular vision for its future," CAP President Neera Tanden said in a statement welcoming the news.
But the job has a lower profile than sought by CAP, which called for the new CEO to report to Obama and Burwell.
HHS said the marketplace CEO would be responsible and accountable for leading the federal marketplace, managing relationships with state marketplaces and running the CMS Center for Consumer Information and Insurance Oversight, which regulates health insurance at the federal level.
The job will report to CMS Administrator Marilyn Tavenner, with a dotted line to Burwell.
The marketplace CTO will report to the CEO and work closely with the senior officials within CMS to ensure proper alignment of project technology milestones and deliverables.