Budget director Sylvia Mathews Burwell. (AP Photo/Charles Dharapak)

State insurance regulators want the Obama administration to get more people who understand them into top posts at the U.S. Department of Health and Human Services.

The lack of regulatory expertise at HHS was one of the topics that came up last week in Washington, when 44 members of the National Association of Insurance Commissioners met with President Obama and other administration officials in the White House.

The White House organized the meeting to talk about the end of the 2014 Patient Protection and Affordable Care Act open enrollment period as well as next year’s.

The debate surfaces in the shadow of the administration’s nomination of Sylvia Mathews Burwell, who’s been a MetLife board member but never worked as a state insurance regulator, as the new HSH secretary.

Gary Cohen, the former head of the Center for Consumer Information & Insurance Oversight left his post March 31. CCIIO now has an acting director, Mandy Cohen, who like Burwell, has never worked in insurance regulation at the state level.

The NAIC members told federal officials to get CCIIO a permanent director quickly, NAIC officials said in an announcement of the meeting.

“The new director should rely on the expertise of state insurance regulators as decisions are made,” NAIC officials said.

See also: