Obamacare looks like it’s here to stay. Now the Obama administration plans to better explain to Americans why the law is good for them.
After the Supreme Court declined to gut the law in a decision last week, there’s an opportunity to build on gains in health coverage and also rectify some missteps in the Affordable Care Act’s marketing, Sylvia Mathews Burwell, the U.S. health secretary, told Bloomberg’s Al Hunt in an interview for PBS’s “Charlie Rose” program.
“We as an administration haven’t done as much as we could to make sure people understand the breadth of the benefits,” she said. “The ACA became about a very narrow thing. Even narrower than the uninsured, it became about the marketplace. It is about so much more.”
The court ruled 6-3 on June 25 that subsidies to help people pay their insurance premiums are available nationwide, not just in the 16 states that have built their own insurance marketplaces, called exchanges. While preserving coverage for more than 6 million Americans, the decision didn’t touch on the law’s improvements in health care for many more people, Burwell said.
The Obama administration must ensure “people understand the benefits they get every day that they’re using that are part of the Affordable Care Act,” she said. For example, the law requires insurers to cover children on their parents’ plans until age 26, and forbids out-of-pocket charges for a long list of preventive health services including mammograms.
Many Republicans said after the ruling that they would continue to try to repeal the Affordable Care Act. Former Florida Governor Jeb Bush, who’s running for the Republican nomination to succeed Obama, said he would replace the law with “conservative reforms that empower consumers with more choices and control over their health-care decisions.”
The government hopes to enroll more people next year into private health plans sold under the Affordable Care Act, Burwell said. About 10 million are in the plans now. Obama is also pushing states to take advantage of an expansion of Medicaid, the program that covers low-income people, provided by the law.
Obama traveled to Tennessee on Wednesday to promote Medicaid expansion. It’s one of 22 states with Republican governors or legislatures that have so far refused.
“I’d like to see some good sense spring forth from the good state of Tennessee, see if we can get this thing done,” Obama said in a question-and-answer session at an elementary school in Madison, Tennessee.
Burwell told Hunt that Obama is unlikely to entertain Republican proposals to replace or change the law. That includes repeal of a tax on medical devices, a proposal supported by many Democrats as well as Republicans.
The administration will review legislation seeking to alter the law based on its impact on the affordability and quality of care, whether it expands access to care, and its effect on the economy, she said.
“One of the things that I think is an important part of the conversation about the changes and improvements that we need to make is getting to the substance of ‘What’s the problem that you’re trying to solve, and will the action you’re taking actually solve that problem?’” she said.
An example, she said, is a Republican proposal to raise the threshold at which employers must offer health insurance to part-time workers. Under the Affordable Care Act, the coverage requirement is triggered at 30 hours a week. Republicans want it to be 40 hours. But that “would create more of an issue” because many more people work almost 40 hours a week than 30, she said.
“We believe what we have in front of us is working,” she said of the law.
The full Burwell interview airs Wednesday night on PBS and will be rebroadcast on Bloomberg TV.