01:59 - Source: CNN
Obamacare: What's next?

Story highlights

More trouble for Obamacare puts more pressure on Health Secretary Kathleen Sebelius

Rep. Nick Rahall, D-West Virginia, said 'heads should have rolled' over disastrous roll out

Crisis management expert says federal agencies take the blame and the White House collects the props

Washington CNN  — 

The disastrous roll out of the Affordable Care Act raises a litany of questions about President Barack Obama’s leadership and management ability. But it also begs for an answer to who would take the fall.

As problems mount, Rep. Nick Rahall, D-West Virginia, said Thursday that “heads should have rolled” at the White House.

Health and Human Services Secretary Kathleen Sebelius, the woman in charge of implementing Obamacare, took the blame for a flawed HealthCare.gov website, even as calls mounted – inside and outside of Washington - for her to be fired.

Testifying before a hostile congressional committee, Sebelius said she should be held accountable for the online site that stumbled out of the starting gate on October 1 and won’t be functioning smoothly for most people – according to Obama, himself – until the end of the month.

“I’m responsible,” she told lawmakers.

But Obama had her back. White House Spokesman Jay Carney said the President has “full confidence” in Sebelius.

Eric Dezenhall, crisis management expert and CEO of Dezenhall Resources, said that an age-old White House policy is that federal agencies take the blame and the White House collects the props.

But as letters started landing in people’s mailboxes, notifying them that their health insurance plans were being canceled, Sebelius might have been in deeper hot water, except that Obama promised when selling Obamacare that people could keep their plans if they like them. That was not true in the end.

Obama takes brunt of new storm

People were given false assurance. Sebelius shrunk out of the spotlight as Obama’s unkept promise took the brunt of a new storm.

It culminated in a public apology on Thursday when Obama – also talking about the website – acknowledged that he “fumbled” the launch of his signature domestic policy achievement.

While Obama is taking responsibility publicly, internally he is faced with many questions, including why his staff let him make such a claim if it wasn’t true.

Should Sebelius have known?

She was responsible for overseeing the implementation and creation of the specifics of Obamacare. Additionally, as a former insurance commissioner responsible for approving or rejecting coverage plans for Kansas consumers, it seemed like she would have had an understanding of the impact as federal coverage standards changed to become more robust.

And some insurance commissioners are troubled by the President’s proposal to allow a one year extension of individual health plans – those most likely to be canceled.

Sebelius’ successor, Sandy Praeger, said she and her fellow insurance commissioners around the country warned the administration early on.

“We said from the get-go that if you start taking pieces out of this, it will collapse,” Praeger told the Lawrence Journal World.

Should someone be fired?

“I think there is limited utility in just firing people, but if you need to do it for political reasons, it’s always an option,” Dezenhall said.

Dezenhall cautioned, however, that this is not an acute problem but a chronic one, and firing Sebelius won’t make everything magically better.

Even if Obama chose to fire Sebelius, he would need to replace her, and that may be the ultimate reason why she may stay on for now.

Not only would it take time for a new health secretary to get up to speed, a permanent replacement requires Senate confirmation – lately an unappealing prospect for Obama.

Finding someone else would likely subject Obama to a damaging political fight with Republicans determined to draw as much attention to the problematic components of Obamacare.

CNN senior political analyst Ron Brownstein said that a new health nominee would ensure “virtual certainty” for Republicans to “use this as kind of a way to leverage more concessions from the administration.”

CNN’s chief political analyst, Gloria Borger, said Sebelius’ head would roll at some point.

“He’s very deliberate. In the end, will she go? Eventually. But there are lots of other issues she’s got to deal with first,” Borger said.

But for now, this is Obama’s problem. It is called Obamacare, not Sebeliuscare.

“Hiding ceases to be an option,” Dezenhall said. “Hiding is an option when you have a place to hide and when no one is looking. It’s not an option when there’s no place to hide and everyone’s looking.”