Obamacare Outspent 4-to-1 Leading to Start, Sebelius Says

Kathleen Sebelius, the former U.S. health secretary, assailed opponents of Obamacare, saying they outspent the government 4-to-1 before the start of the health exchanges that signed up 8 million Americans for coverage.

Sebelius, who resigned April 10, spoke publicly today for the first time since she left the administration on June 6. Her comments came at a conference sponsored by Enroll America, the nonprofit group based in Washington that led efforts to sign up Americans in 11 states under the Patient Protection and Affordable Care Act. In a video taped for the conference, President Barack Obama thanked enrollment workers and joined Sebelius in lashing out at opponents of the law.

“We had right-wing media, leadership in Congress who was determined on the House side to stop this law at any cost, shadow political organizations, hostile governors, all working to make sure you couldn’t do the job that was so important,” Sebelius said.

Sebelius helped Obama shepherd the 2010 health-care law through Congress, oversaw the writing of tens of thousands of pages of regulations and traveled regularly to persuade Americans to sign up for coverage through the new online marketplaces. Her tenure as health secretary came to a close after healthcare.gov, the federal website, started Oct. 1 with errors so severe that few people could sign up before December.

“The former secretary, who presided over the train-wreck roll out of the president’s health-care law, is right: House Republicans are determined to protect the American people from it because it is raising health-care costs and costing jobs,” Michael Steel, a spokesman for House Speaker John Boehner, an Ohio Republican, said in an e-mail.

Trying Time

Sebelius, in response to a question from Anne Filipic, Enroll America’s president, said the website’s initial failures made for a personally difficult time.

“I would trade those eight weeks in October and November in a heartbeat,” she said. “The most terrifying couple days in that process were November 30th and the 29th and thinking, ‘I really hope this is going to work.’”

Organizers planned the conference to help enrollment workers prepare for the second year of the law, when at least 13 million people are expected to be signed up in private plans, according to the Congressional Budget Office. Enrollment for 2015 opens Nov. 15.

Dan Hilferty, chief executive officer of Philadelphia-based Independence Blue Cross Blue Shield, said his company had enrolled 285,000 people through the insurance exchanges after budgeting for fewer than 100,000. About 30 percent of the customers were 18 to 34 years old. The demographic, considered a proxy for healthy people, is a sweet spot for insurers, who are required under the law to cover anyone regardless of illness.

Enrollment Success

“That should speak to the success that you have fostered during this enrollment period,” Hilferty told conference participants.

The company also enrolled “several hundred thousand” people in its state Medicaid plans, which cover low-income Americans, he said. Sebelius said the government program, expanded under the health-law to cover more working adults, has added 6 million people since October.

Many people who signed up for coverage under the law were previously uninsured, contrary to what skeptics predicted, said Drew Altman, president of the Menlo Park, California-based Kaiser Family Foundation. His nonprofit research group will release a survey on June 19 showing “that a very large percentage of those who got coverage in the exchanges were previously uninsured,” he said.

Medicaid Expansion

As health secretary, Sebelius tempered her criticism of opponents of the law, knowing that Republican governors in more than half the states were key to the Medicaid expansion. The Supreme Court made the expansion optional for states in a 2012 decision, putting control in statehouses and governors’ mansions.

Twenty-four states, all with Republican governors or Republican-controlled legislatures, haven’t expanded the program, according to the Kaiser foundation. Sebelius today called that decision “heartbreaking” and criticized efforts by Republicans in some states to hamper enrollment workers.

Advocates for the law “really combated not only relentless misinformation but relentless obstruction; people were told they could not come onto city or county property to do their jobs; people were forced to give fingerprints or pay a fee” to register as enrollment assisters, she said.

Spending Effort

Sebelius said opponents of the law outspent the government 4-to-1 before October, measured by “direct expenditures against the Affordable Care Act.” The government spent about $70 million promoting the law, she said.

Sebelius saw her relationships with congressional Republicans erode last year after it was discovered that she had contacted health-care companies regulated by her department to solicit support for Enroll America. The group was founded by the consumer advocate Families USA in 2010 to help educate Americans on the health-care law and drive outreach efforts. Filipic, a former Obama aide, was appointed president in early 2013.

“The other side has billionaires funding campaigns to scare the very people the Affordable Care Act would help,” Obama said in his video. “Together we’re going to make sure this law works for everybody and keep fighting to restore opportunity for all.”

Sebelius’s successor, former Obama budget director Sylvia Mathews Burwell, assumed leadership of the health department on June 9.

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