The day after President Donald Trump announced his plans to strangle Obamacare with his own hands by withholding subsidies, Kathleen Sebelius gave an uncharacteristically impassioned defense of the law she was in charge of implementing as Barack Obama’s head of Health and Human Services.
“It’s just nonsense” the way it’s been portrayed as a government takeover of health care, she said at a conference of moderate Midwestern Democrats just down the street from the Iowa State Capitol. Then she reworded that assessment: “Frankly, it’s bullshit.”
In Washington, the former Kansas governor and insurance commissioner was seen as so even-tempered she could have been the Vulcan cousin of the president she served.
“Some Democrats,” the National Journal wrote at the end of her tenure, “…hated her approach and privately pushed the White House to shake up its messaging, if not its messenger. But Sebelius’ unemotional demeanor — while authentic — was what the administration wanted strategically.”
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Well, that was not the Kathleen Sebelius who spoke to Democrats here, at an all-day “New Democracy” discussion on winning back rural America from Republicans.
“Health care is our issue, and we have to stop running from it!” she told them.
Just as she was blasting Republican plans to “go after the underlying Medicaid program, the safety net in place for 50 years,” a screaming child on another floor of the State Historical Museum of Iowa began to punctuate her remarks with shrieks, and she joined right in and yelled, too: “Aaaaah! You’re right,’’ she told the unseen kid, “it is scary.”
When a self-employed woman in the crowd said she’d lose her health insurance without the federal subsidies to insurance companies to defray her out-of-pocket costs, Sebelius told her that no, she wouldn’t because the Affordable Care Act is “still the law.” And even if the man who may be one of “the worst AGs in the history of our country says it’s legal,’’ to stop paying, “it isn’t.”
The president, she said, is “choosing not to pay subsidies. He could choose tomorrow to pay them.”
Given all his flip-flops, maybe he will. But on Thursday, the president did announce two ACA-killing moves: The government will stop paying health insurance companies to keep costs down for low-income Americans. As a result, insurance premiums will go up even more and even faster, and more insurance companies will leave the government exchanges created under Obamacare.
The changes won’t be immediate, but under this plan, those companies will once again be able to sell junk insurance, too, as they did before the law passed. And of course coverage that doesn’t offer much is cheaper.
Sebelius said Republicans like Iowa’s governor, Kim Reynolds, should fight this: “She needs to insist that her president follow the law and say there are people in Iowa who are going to be screwed by this.”
She also had some thoughts for and about the elected officials in her home state of Kansas. They frustrate her by going on about how much they care about health care in rural areas, “yet they won’t do anything to change the rates” that Medicaid pays.
Of KanCare, the state’s widely criticized Medicaid program, she said, “the way they’ve chosen to save money in Kansas is to cut back on services” and oversight. “It’s not that you can’t do it in the private sector, but you can’t do it with a hands-off attitude.”
In not expanding Medicaid under the ACA, “we’re one of the brilliant 19 states that has chosen to play politics with people’s lives.”
She’s right about that, and may even be right, too, that health care could be a winning issue for her party in next year’s midterms.
But that will only happen if Trump succeeds in killing what instead ought to be cured, and it will be too late then to regret that it ever came to that.