It is not surprising, then, that in a January interview with Julie Appleby of Kaiser Health News, Leavitt signaled considerable empathy for the besieged team trying to get the ACA launched. Asked about one of the administration's many adjustments to rules and deadlines -- the extension of catastrophic plan eligibility to those whose 2013 plans were canceled -- he offered a striking metaphor that captures the administration's mindset and m.o.:
They’re trying to find ways to keep enough momentum moving forward. Think about it like a big snowstorm, and you’re trying to drive a car uphill. The most important thing is to keep momentum and keep it out of the ditch. You might swerve from side to side, or might even do a circle or two. But if you can keep the momentum going up the hill, then you can ultimately succeed. They’re driving on a slick road up a stormy hill. They will do some things they hadn’t anticipated. But forward momentum is their game. At the end of the day, we’ll find out. They may get there; they may end up in a ditch. They may have a collision. Who knows?That image seems particularly apt in the wake of the administration's latest swerve, the extension of "special enrollment periods" past March 31 to anyone who claims to have tried to enroll in a health plan through Healthcare.gov before that point. Equally apt is Leavitt's less metaphorical take on the imperative driving moves like this:
KHN: What is your take on enrollment so far?"What they have to do" indeed. Ignore the critics and get the uninsured enrolled.
Leavitt: It’s unlikely they will hit their targets. It seemed unlikely to me they would hit targets at the beginning. But we’re seeing more disruption than anticipated occurring. [If they don’t get the enrollment] needed to make it actuarially sound, we’re likely to see higher premiums. The objective for the administration at a moment like this is to keep it going at whatever cost. At some point in time, it will smooth it out. It’s a logical strategy; it’s what they have to do.