Changes likely after Affordable Care Act dust settles

WASHINGTON (CNN) — Once the Affordable Care Act fiasco dust settles, it only seems natural. Even if President Barack Obama likes the team at the helm of his second term, he will likely not be able to keep it.

Obama is expected by former administration officials to soon make a course correction in his administration to address the glaring mistakes made in the roll-out of the Affordable Care Act.

“I think they’re going to have to hold somebody accountable for the botched roll-out and the website not working –somebody at HHS or a group of people,” said Robert Gibbs, Obama’s press secretary during his first term, on NBC’s “Today” show on Monday.

“I think if this were to happen in the private sector, somebody would have probably already lost their job and I think the only way to restore ultimate confidence in going forward is to make sure that whoever was in charge of this isn’t in charge of the long-term health care plan,” Gibbs said.

The question is which heads will roll.

Conventional wisdom in Washington is that the President is stuck with Health and Human Services Secretary Kathleen Sebelius. That exercise ends with two obvious questions: Who replaces her? And how does that person get confirmed?

“The real problem here is not the White House staff, but Sebelius and the team of incompetents that put President Obama in this position,” a top Democratic strategist told CNN on the condition of anonymity. “That said, they believe they can’t confirm anyone — so the GOP is Sebelius’ best job security. Perverse.”

But a top GOP congressional aide argued replacing Sebelius would be difficult, but not impossible.

“The confirmation hearing would be rough. So it’s not that he can’t. It’s that he doesn’t want to,” the aide said.

The focus on HHS is an obvious one. Consider the President’s stunning admission at last Thursday’s news conference that he was never “directly” told about the problems plaguing HealthCare.gov.

“I was not informed directly that the website would not be working the way it was supposed to. Had I been informed, I wouldn’t be going out saying, ‘Boy, this is going to be great,’ ” Obama said.

But deep inside Health and Human Services, officials were well aware of the site’s bugs. In e-mails released by the Republican controlled House Energy and Commerce Committee Friday, one HHS official told contractors working on the site he feared healthcare.gov would “crash” after takeoff.

Publicly, White House officials maintain the focus is on fixing the site and the Affordable Care Act’s other big problem: consumers who are losing their insurance coverage despite the President’s pledge “If you like your plan you can keep it.”

“The President right now has tasked his team — and everyone involved in this effort — to the work needed to improve the website and to improve the implementation of the Affordable Care Act,” White House press secretary Jay Carney told reporters on Friday.

But once the White House moves beyond “right now,” administration officials privately acknowledge the inevitable. The Wall Street Journal reported Sunday the White House has begun an internal assessment of what went wrong.

David Plouffe, a former senior adviser to the President, indicated Sunday a staff shakeup is coming.

“So I think once the website gets fixed, and it will, then you have to step back and say, ‘OK, what do I need to have confidence going forward that I can to implement this law?’ ” Plouffe told ABC’s “This Week.”

The bureaucratic failings that led up to the botched implementation of the federal health insurance marketplace have invited comparisons to former President George W. Bush’s response to the aftermath of Hurricane Katrina.

Five days after Katrina, Bush infamously praised the work of Michael Brown, then director of the Federal Emergency Management Agency.

“Brownie, you’re doing a heck of a job,” Bush said.

But 15 days after the storm, Brown had stepped down.

“The President appreciates Mike Brown’s service,” Bush’s White House press secretary Scott McClellan said at the time.

Disclosures of Brown’s utter lack of any extensive emergency management training accelerated his departure. Brown was a top official at the International Arabian Horse Association before he was brought into FEMA by his friend, Joe Allbaugh, Bush’s former campaign manager.

But Bush’s searing Katrina saga stands in stark contrast to the President’s handling of Obamacare’s bumbling, humbling roll-out. There have been no high-profile firings and White House officials maintain the President still has confidence in Sebelius.

And there are other notable differences. Unlike Brown’s inexperience, Sebelius had been a state insurance commissioner in Kansas before becoming that state’s governor prior to landing the job at HHS.

Fiercely loyal, the President is known to loathe giving the opposition “scalps.”

“Rolling heads just isn’t ‘No-Drama-Obama’s’ way. In this case it ought to be,” said Larry Sabato, the director of the University of Virginia’s Center for Politics. “A president’s credibility sometimes demands a pound of flesh.”

CNN political contributor and former White House adviser David Gergen points to the shakeup in the second term of the Reagan administration following the initial revelations of the Iran-Contra affair.

“They ran almost a model of how to get rid of something,” Gergen said.

Gergen recommends a “thundercloud” approach to Obama’s current troubles — in other words, a rash of firings and hirings of heavyweights to the White House staff that grabs the nation’s attention.

“They still have time to recover,” Gergen said.

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