It was a turbulent five years for Kathleen Sebelius as she midwifed the newborn Affordable Care Act, certainly the most significant health care legislation in a generation.
As President Barack Obama’s first secretary of Health and Human Services, the former Kansas governor took much of the criticism for the ACA’s notoriously flawed healthcare.gov website, which frustrated many people as they tried to sign up for insurance plans. Some Republican members of Congress, including Sen. Pat Roberts, a fellow Kansan, called for her resignation.
She ended up apologizing for the glitches. “You deserve better,” she said. But she stayed the course, not tendering her resignation until 2014, when implementation of the ACA was well along.
Speaking last week at the annual luncheon of the Health Care Foundation of Greater Kansas City, Sebelius expressed pride in what the ACA has accomplished. The nation has seen a historic drop in the number of people without health insurance, she said, while health care inflation has been running at the lowest rate in 50 years.
Those are the facts, Sebelius said. “The debate sounds different, but those are the facts on the ground.”
Sebelius was confident that the ACA was so “intimately entwined” into the fabric of the nation’s health care system that it would be impossible to dismantle it wholesale, as some Republicans presidential contenders vow.
Any politician promising to repeal the ACA “is just not telling the truth,” she said. “It really can’t happen.”
The ACA has changed the way doctors and hospitals are paid, how health insurance companies price their plans and how millions of people get health care coverage. If you took away the ACA, there would be nothing left to go back to, Sebelius said.
Unfinished business remains, she said. The ACA provides states money to expand their Medicaid programs to cover more working poor families and individuals. Kansas and Missouri are among the minority of states that haven’t chosen to do that.
That means Missouri is giving up $9 million per day in extra federal Medicaid funds, Sebelius said. Kansas is giving up $1.4 million per day.
“The cost is huge,” she said. “That’s our tax money, and right now, it’s going to the 29 states” that have expanded their Medicaid programs.
Sebelius said she’s been dividing her time between Topeka and Washington. She’s on four corporate boards and is involved in a health care policy project at the Aspen Institute think tank. And like many former government officials, she’s making the rounds as a luncheon speaker.