In a move that could raise potential conflict-of-interest issues, former Sen. Ben Nelson (D-Neb.) was hired Tuesday as CEO of the National Association of Insurance Commissioners while simultaneously signing on as a senior adviser to a public relations firm that services groups that lobby the nation's governors.
A former governor, insurance company executive and state insurance director, Nelson kicked up a storm during the debate over the Patient Protection and Affordable Care Act by insisting on special Medicaid provisions for his home state. The so-called Cornhusker kickback was dropped in the final bill. He takes over the advocacy organization for state insurance officials at a pivotal time, as states wrestle with implementation of the major provisions of the 2010 federal healthcare law.
On the same day he started at the NAIC, Nelson also began full-time work with Agenda, a national communications and public affairs firm that specializes in building coalitions to advocate state policy changes.
Craig Pattee, a founding partner of Agenda, said the specifics of Nelson's role there were not yet determined, but that Nelson “will recuse himself from any clients that conflict with any position that NAIC takes.”
Pattee's group focuses particularly on advocacy efforts targeting governors, which could benefit from the advice of a former governor. “As governors and states look to implement healthcare, Nelson and Schaffer will be looking to highlight best practices,” Pattee said about new hires Nelson and former Republican North Dakota Gov. Ed Schafer.
Agenda works to build support coalitions to advocate state policy changes but it does not lobby, according to Pattee. “Obamacare has basically been left to governors for implementation,” he said.
An NAIC spokesman did not respond to e-mailed questions about Nelson's role or potential conflicts and said Nelson was unavailable for interviews.
“After years in government, this is a homecoming for me,” Nelson said in a news release
. “It is also an opportunity to advance the work of the NAIC to safeguard the insurance sector through the promotion of our outstanding regulatory framework. In my new role, I look forward to continuing our relationship with the Federal Insurance Office as well as working with state regulators on matters affecting the economy and consumers.”
Nelson replaced Therese Vaughan, who announced in August 2012 that she would step down early this year
Nelson was described by one insurance policy expert as “bipartisan and pro-business” and that he was widely sought-after when he retired from Congress 20 days ago.
“He is a terrific choice,” Karen Ignagni, president and CEO of America's Health Insurance Plans, said in an emailed statement. “He has the experience and expertise needed to lead the organization during this critical time.”
Jim Donelon, president of NAIC and Louisiana insurance commissioner, said in a news release that Nelson's impressive credentials and deep knowledge of state insurance regulation “are simply unmatched ... His rare and valuable combination of experience in insurance and government will be a tremendous asset to our organization. In addition to skillfully navigating the political arena, the stalwart leadership and collaborative nature that marked his time in public service will be integral to elevating our efforts on Capitol Hill,” Donelon said. “Moreover, as a former regulator and Executive Vice President of the NAIC, Senator Nelson has a keen understanding of the insurance marketplace, which will make him an effective advocate for the preservation of our state-based system of regulation.”
Nelson was a pivotal figure in the narrow passage of the Affordable Care Act, for which he provided the final vote.
“The key issues that NAIC will be focusing on are issues that he can provide some real leadership on,” said Ron Pollack, executive director of Families USA, a leading advocacy group behind the law. “What is absolutely essential is that the new insurance market reforms are implemented as effectively as possible and he will be helpful in that direction.”
Nelson's arrival at the advocacy group for insurance officials comes as those officials are juggling a range of implementation issues associated with the federal healthcare law, including coverage expansions through insurance exchanges and expansions of Medicaid programs slated to begin in 2014.
At least one insurance commissioner is taking the lead in launching a state-run health insurance exchange. Mississippi Commissioner of Insurance Mike Chaney has submitted an application for a state-run health insurance exchange to launch next year, despite opposition from the Republican governor and legislative leadership in that state.