The Affordable Care Act public exchange system is heading toward its fourth annual open enrollment period with a fair amount of turmoil at the top.

Open enrollment for 2017 is set to start Nov. 1 and end Jan. 31. The exchange system is having to cope with insurers’ concerns about how profitable covering its users really is, and ferocious competition from Medicaid and Medicaid-like programs.

Related: Feds throw flooded exchange plan issuers a floatie

The fate of Kevin Counihan, the head of the Centers for Medicare & Medicaid Services division that oversees HealthCare.gov, could depend on who wins the presidential election.

Either President Clinton or President Trump could tell Counihan, “You’re fired.”

Either could beg for him to stay on at least until the end of the open enrollment period.

Meanwhile, several of the state-based exchanges (and state-based exchanges that happen to use HealthCare.gov to handle the techy stuff) are going back into the fire with new chiefs. 

Related: 5 state-based exchange steps toward 2017

For a look at three state-based exchanges undergoing changes at the top, along with videos related to those exchanges, read on.

Carolyn Quattrocki, Maryland’s outgoing exchange chief, appeared in this promotional video for the open enrollment period for 2016 coverage. (Video: MarylandConnect/YouTube)

1. Maryland 

Carolyn Quattrocki, an executive director who helped stabilize Baltimore-based Maryland Health Connect after it faced glitches and headlines about executive vacations, is leaving to become her state’s deputy attorney general.

The Maryland Health Benefit Exchange board, the body that oversees Maryland Health Connect, has picked Jonathan Kromm to be acting executive director.

Kromm, who has been the deputy executive director, started out in policy research in Washington, D.C. at the American Cancer Society. He has a bachelor’s degree in psychology from the University of Pennsylvania, and a doctorate in health policy and management from Johns Hopkins.

Related: PPACA exchange may transfer callers to brokers

 

Here’s a video featuring Bruce Gilbert from a Silver State Health Insurance Exchange board meeting that took place in January. (Video: Silver State Health Insurance Exchange/YouTube)

2. Nevada 

Bruce Gilbert, the executive director of the Carson City, Nevada-based Silver State Health Insurance Exchange, is leaving to work for TriHealth, a Cincinnati-based health care system.

The exchange board has picked Heather Korbulic to be permanent executive director.

Gilbert led the exchange as it dealt with technical problems and ultimately decided to use the federal HealthCare.gov system to handle enrollment and policy support.

Korbulic, his successor, has been chief operations officer at the exchange since August 2015. Before that, she was the state’s long term care ombudsman.

She worked for about two years as a business manager at Home Instead Senior Care, an Omaha, Nebraska-based home care agency.

She has a bachelor’s degree from the University of Oregon.

Related: Nevada exchange head: HealthCare.gov costs too much

 

A reporter from the American Journal of Managed Care interviewed Amy Dowd, the former beWellnm.com CEO, in March. (Video: AMJCtv.com/YouTube)

3. New Mexico 

Amy Dowd, the departing chief executive officer of beWellnm.com, New Mexico’s Albuquerque-based exchange, started Your Health Idaho, Idaho’s public exchange, before coming to New Mexico in August 2014.

She’s leaving to become vice president of marketplace operations at Long Beach, California-based Molina Healthcare, a Medicaid carrier with a growing exchange plan division.

The board of the exchange has named Linda Wedeen interim CEO.

Wedeen has been senior director of communications, marketing and outreach.

The board has put an executive search committee in charge of choosing a new CEO.

Wedeen has worked as an executive communications manager at Palo Alto, California-based Hewlett Packard and a senior vice president of strategic marketing at Albuquerque-based First Community bank as well as in the health care sector.

She has a bachelor’s degree in art education from the State University of New York at Buffalo, and a master’s degree in organizational leadership from the University of Phoenix.

Related: 

Optum blasts Minnesota exchange systems

PPACA exchanges: The human side

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