The Government Accountability Office, Congress's investigative arm, released a report early Monday on Health and Human Services Secretary Kathleen Sebelius' fundraising on behalf of Enroll America, a nonprofit founded by former Obama campaign and White House staffers to help promote enrollment in the federal exchanges.
Previously, Sebelius was the only public official to come forward and confirm she was involved in outside fundraising to promote Obamacare, but the GAO report also details activities of a senior White House aide.
Sebelius has acknowledged that after Congress stopped providing money for Obamacare's implementation in 2011, she solicited five entities to support Enroll America, but only asked for direct financial support from private entities that HHS does not regulate. Those entities included the Robert Wood Johnson Foundation and H&R Block.
HHS told the GAO that Sebelius made phone calls to the CEOs of three other organizations, Kaiser, Ascension Health and Johnson & Johnson, but only asked for nonfinancial support such as “technical assistance.”
The GAO report, though, added that during its investigation, a “representative” of the Robert Wood Johnson Foundation said the deputy assistant to the president for health policy during a 2012 discussion “indicated a hope that R.W.J.F. would provide a significant financial contribution to support [Enroll America's] efforts" and said Enroll America and other similar national enrollment organizations would likely need $30 million to finance a national Obamacare promotional effort.
The report does not name the deputy assistant to the president for health policy. Jeanne Lambrew has been serving in that position since March 2011, according to a report in the Washington Post.
According to the GAO report, the White House said that the aide did not make a specific funding request on behalf of Enroll America and denied that the staffer identified a specific amount needed for outside national outreach efforts.
Republican lawmakers say the report raises new questions about the White House's involvement in the fundraising and shows that the administration is willing to push legal boundaries to support Obama's signature legislative initiative.
"This report on the secretary's fundraising for Obamacare fits into a pattern of abuses of government office to pursue political ends,” said Greg Dolan, a spokesman for Rep. Jack Kingston, R-Ga. “The person in charge of the government takeover of health care should not be asking CEOs to bankroll a partisan marketing campaign, period."
Kingston was one of five lawmakers who requested the GAO probe. The others were Republican Sens. Lamar Alexander of Tennessee and Orrin Hatch of Utah, as well as Reps. Dave Camp and Fred Upton of Michigan. Kingston chairs the appropriations subcommittee that directs health care spending.
"The self-proclaimed 'most transparent administration in history' has been anything but transparent in implementing the president's health care law,” Upton said a statement emailed to the Washington Examiner.
“Despite every resistance from administration officials, my colleagues and I have always asked the difficult questions and held the administration accountable for the law's many broken promises,” he added. “Our thoughtful oversight continues despite the administration's attempts to keep the public in the dark."
In addition, HHS told the GAO that Sebelius made phone calls to the CEOs of three other organizations, Kaiser, Ascension Health and Johnson & Johnson but only asked for nonfinancial support such as “technical assistance.”
All along, Sebelius has claimed her fundraising activity on behalf of Enroll America was both legal and ethical because the Public Health Services Act allows HHS officials to engage outside groups to publicly promote public health initiatives.
The White House is not covered by the Public Health Service Act, so a separate group of executive branch ethics rules that place stricter limits on fundraising would apply.
Before the GAO report came out, White House officials previously said they did not sign off on Sebelius' fundraising, although they were generally aware of the outreach plans.
The GAO report does not offer a legal opinion about whether the White House aide or Sebelius violated federal law but found no evidence that the outgoing secretary violated the Anti-Deficiency Act, as Republicans charged when the solicitations first became public in May of last year.
The Anti-Deficiency Act prohibits government agencies from accepting voluntary services or donations.
For an Anti-Deficiency Act violation to have occurred, the GAO found that HHS would have to incur a potential future obligation to pay Enroll America for its services.
It said there is likely no such violation since GAO found no informal or contractual agreements between HHS and Enroll America. The agency also found that HHS did not incur any internal expenses, so the department likely did not violate the Anti-Deficiency Act rules against spending without an appropriation.
Sebelius and House Democrats argue that engaging public-private partnerships to help promote the law is similar to what President George W. Bush's administration did to promote the prescription drug benefit in Medicare Part D expansion and the Children's Health Insurance Program.
A spokesman for Sen. Lamar Alexander, R-Tenn., one of the five lawmakers who had requested the report, said the senator hoped Sebelius' replacement “will not ask the entities she regulates to support the president's allies.”
The Robert Wood Johnson Foundation, a nonprofit that supports anti-obesity and other health outreach campaigns, last year said it had contributed at least $14 million to Enroll America. It owns more than $1 billion worth of stock in Johnson & Johnson, which HHS regulates. The Food and Drug Administration, which is part of HHS, regulates Johnson & Johnson's drugs and medical devices.
H&R Block stands to reap a windfall from the implementation of Obamacare in helping assist clients in discerning whether they qualify for tax subsidies when enrolling in the federal insurance exchanges.
This story was published at 2:22 p.m. and has been updated.