Interview with HHS Secretary Kathleen Sebelius

Secretary: Well we clearly could have done a better job should have done a better job with a top line message I think that the health care system is pretty complicated and the law contains a lot of different parts. Some of it changes the insurance system giving families more freedom, putting insurance companies under a new set of rules.  Part of this changes the healthcare system for the better, improving public health and hiring more doctors and nurses and I think what happened along the way is we tried to say everything to everybody and as a consequence a lot of people just didn’t hear anything at all.

The Hill: So is defense easier than maybe the first time around?

Secretary: Well I think what’s easier is now that now we’re 10 months into the law, now that the benefits, the early benefits are out and people are really in their insurance plans in 2011 beginning to connect with them.  They understand it’s no longer a theory it’s about them and their families and that makes anything that Congress does more than a policy you read about in a newspaper.  It’s giving a lot of consumers’ freedoms that they never had, freedom from insurance company rules, freedom from being terrified that their children with a preexisting condition couldn’t get insurance coverage.  The new website is being used over and over again by folks who never had a way to compare prices or see what was available to them.  So as people begin to personalize the law that was passed I think we’re seeing it become much more popular.

The Hill: The State of the Union is coming up.  Just wondering what you would like to hear President Obama to say about healthcare?

Secretary: Well I think that the President from the outset has focused on getting the economy back on track and the fact that healthcare is a key part of getting the economy back on track we can’t possibly afford to go back to the days where premiums were skyrocketing, where underlying healthcare costs were far outpacing any kind of inflation, bankrupting families, bankrupting state and local governments, make it more difficult for our employers to compete in a global market.  So this law sets a brand new platform and in addition to the insurance benefits that people are becoming aware of I think there’s a great opportunity to improve health for all Americans, have a system that delivers better healthcare and we’re going to have a much more prosperous country as a result of it and I think the President is likely to touch on some of those themes.

The Hill:  Yet you have Republicans who just repealed it in the House. They’re pushing for the Senate to hold a vote. What should the message be to the Republicans across the aisle about how to work together going forward on health care reform?

Secretary: Well I’m hopeful that they’ll begin hearing from their constituents and I know that’s beginning to happen across the country that it isn’t not really a debate with the department of health and human services, it’s a debate with the folks who are now seeing some freedoms from old rules that give them choices that they couldn’t make before.  The 55-65 year olds who can think about after 2014 changing jobs or starting a new business who right now are job-locked because they’re terrifying about losing their insurance coverage. I hope that we can work together around some areas where the bill can be improved or we can certainly make it better but recognize that this is the new platform.  It’s better for our constituents it’s also better for the whole health system.  We spend a lot of money now and don’t get such great results so that can improve with the new bill.

The Hill: I want to go to something that Republicans brought up in the debate.  They want to know why over 200 groups or companies were given exemptions to certain part of the law.  They are saying it proves either one of two things; that it’s a gift to Democratic allies or that it’s proof that the law isn’t working.  What’s going to be your defense against that?

Secretary: Well first of all I think both are pretty ludicrous, the provisions in the law always gave some flexibility to me as secretary.  The goal all along was to get from 2010, when the President signed the bill to 2014 when we’ll have some new market choices for small businesses owners and individuals with as little disruptions as possible.  I find it somewhat ironic that people who are always demanding flexibility from the Federal government are now criticizing flexibility from the Federal government. This is about balancing what people have right now, not wanting to get rid of coverage even if the coverage may not be the best coverage in the world it’s something. Until we get to the point where state based exchanges, new markets with private insurance companies are up and running so this is a measured response.  As companies come in we don’t pick and choose who gets the waivers companies have come, employers have come to us with these requests they’re evaluated and by and large most of them are granted and they are granted on the basis that we don’t want to disrupt the marketplace, we don’t want to take away peoples’ health insurance before they have some realistic other choices.

The Hill: The fact that they came out with this request almost immediately do you think that bodes poorly for how you’re going to work with the new House majority in this Congress?

Secretary:  I hope not. I’m hoping that the new House majority can look forward and stop looking back.  What they have done with the vote on repeal is really kind of recycling the old arguments and making some campaign promises that people made on the trial a reality but taking up a lot of time and energy in the meantime.  I’m hoping that what we can do is look at the challenges that we have going forward, recognize that this is the law it is the platform that we have to work with and figure out how working together we can not only implement it in a timely and effective fashion connecting people to the benefits and freedoms that they’re going to have but also make improvements along the way.

The Hill: I want to ask you about something else the Republicans brought up.  They said they are going to introduce, or have introduced two abortion bills including one that relates to banning taxpayer funding for abortion included in their form law.  There was last year the Stupak Amendment that said no tax payer funding for abortion and then President Obama had signed that executive order which said exactly that – didn’t have the force of law.  But given he had signed the order, is this something that the administration is going to get behind?

Secretary: Well we’ll certainly take a look at it, again the reality is that since the Hyde Amendment that was passed 30 years ago, there is no taxpayer funding for abortion. Let me say that again there is no taxpayer funding for abortion. Not at community health centers, not as part of the new bill, not as part of any of the services we have delivered.  That has been the case for the last 30 years. So language matters, we’ll take a look at the measures.  The president made it very clear in signing the executive order, we intend to carry out the executive order but it doesn’t change anything that has been done under Democrats and Republicans in this department for 30 years.

The Hill: President Obama said he is eager and willing to work with Republicans on ways to improve the reform law.  Where could you see elements of improvement happening?

Secretary: Well I’ll give you one quick example that frankly we’ve been talking about almost since the bill was passed, the house has passed it three or four times, senate republicans blocked this measure from actually being repealed.  There’s a provision right now that would require small businesses owners to fill out expense reports as part of their 1099 form.  The President said immediately “we need to get rid of it.”  It was added to the bill; it has far more burden than benefit.  Republicans right now are playing politics.  They keep stopping the repeal of the law even though everybody agrees it should change. So I’m hoping that we really can get to realistic discussions.  If everybody wants a 1099 to go, let’s get rid of it and move on.

The Hill: Any others?

Secretary: Well that’s the first one that comes to mind but we’re happy to talk about other areas that certainly can be improved as we move along but the 1099 unfortunately is an area where everybody agrees it should go and yet again through partisan gamesmanship the repeal is continued to be stopped so I’m hoping again that they’ll come to the table in good faith.  If there’s agreement that something needs to be changes let’s do it.

The Hill: Thank you for your time Madam Secretary.