Health secretary compares Care Act to civil rights fight

Health secretary, SEIU push Obamacare

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The ongoing effort to provide health coverage for uninsured Americans is reminiscent of the fight for civil rights, said U.S. Health and Human Services Secretary Kathleen Sebelius.

She was in Pittsburgh Tuesday to promote the Affordable Care Act and announce a new outreach partnership with the SEIU, a 2 million-member union that will spread the word about "Obamacare" and help people sign up for coverage once the new federal health care marketplace opens for business Oct. 1.

Ms. Sebelius said the civil rights fight, whose crescendo came 50 years ago with Martin Luther King Jr.'s famous "Dream" speech, has echoes in the ongoing battle between the Obama administration and its Republican foes, who want to see the 2010 health care overhaul repealed, defunded or otherwise handicapped.

Sebelius talks about Affordable Care Act

U.S. Secretary of Health and Human Services Kathleen Sebelius spoke at Allegheny General Hospital about the benefits of the Affordable Care Act. (Video by Nate Guidry; 9/10/2013)

"Not having affordable health care in the richest country on Earth really divides us into societies who have access to some of the best health care the world has ever seen, and folks who don't," she said Tuesday.

She's in the middle of a multi-state trip to promote the law and explain how the uninsured will be able to use the online "exchanges" to comparison shop for health care policies from private insurers starting next month.

Of the law's GOP opponents, the former Kansas governor said the continued pushback isn't as surprising as it is disappointing.

"This is such an important moment for so many people in this country, who have [just] not had access to affordable health care. I was hopeful that certainly once the Supreme Court upheld the law as constitutional, maybe the debate would end. And then I was more hopeful once the president was re-elected, it would become clear that this was the law," she said.

"We clearly have some members who would rather debate the past than move forward to talk about how people can take advantage of the benefits."

Despite criticisms of the health exchanges and the Affordable Care Act overall, once families without insurance understand how it works, "we find that support goes up enormously," she said.

Ms. Sebelius was one of several speakers invited to a press event at Allegheny General Hospital, where the SEIU announced that it would be recruiting and training members to spread the word about how to sign up for federally subsidized health care policies, which will provide coverage starting Jan. 1 for those who sign up for a policy by Dec. 15.

The union will "get on the front lines" in advocating for the law and explaining how it works to uninsured, low-income and minority communities, said Mary Kay Henry, president of the SEIU.

In Pennsylvania, that advocacy role will fall largely to surrogates because the state has declined to build its own online health care exchange and because Pennsylvania has so far declined to expand its Medicaid program to accept more poor families.

In states that are operating their own insurance exchanges and expanding Medicaid, those governments are helping to spread the word about the looming changes to the nation's health care system.

Ms. Sebelius said even if things are different at the state level in Pennsylvania, there has been support from mayors and other public officials who are committed.

She also said the public relations campaign will have to be creative to reach the under-35 age group, whose participation in the health care system is critical to the plan's success.

"The typical advertising campaign will not be as successful with this age group," she said. "The White House had an outreach meeting where everyone from [actress] Amy Poehler to [pop singer] Katy Perry and others were [asking] how they could help."

Regarding Pennsylvania Gov. Tom Corbett's reluctance to expand the Medicaid program, which provides health insurance to the poor and disabled, Ms. Sebelius said the state was doing a disservice to its 1.2 million uninsured and the hundreds of thousands who would be eligible for coverage under such an expansion.

She also noted the state is passing on $17 billion in federal funding over five years, which would pay for new enrollees in the state's Medicaid plan. "We hope that they will see this as a return on investment that is too good to pass up," she said.

Under the act, the federal government will cover 100 percent of the cost of Medicaid expansion for the first three years, gradually reducing its support to 90 percent by the end of the decade.

One of Mr. Corbett's hang-ups related to the Medicaid expansion is how to handle the children now enrolled in the state's Children's Health Insurance Program. Under the federal health care law, many of the children whose families are eligible for Medicaid would be shifted out of CHIP and into Medicaid.

The state has concerns about coverage continuity, but Ms. Sebelius said those wrinkles can be ironed out and noted that in most cases Medicaid benefits are more generous than CHIP benefits.

"Having children [in] the Medicaid program means that families would actually have insurance coverage together. ... They'd be able to see the same provider, they'd be in the same network."

Under the Affordable Care Act, children living in families whose income is up to 138 percent of the federal poverty line could be shifted into Medicaid. Children whose families make too much to be eligible for Medicaid could still be eligible for CHIP, Ms. Sebelius said.

The state still thinks it makes more sense for those 50,000 children to remain in CHIP. On Tuesday, state Insurance Department Commissioner Michael Consedine said Health and Human Services's interpretation of the law is disappointing, and said the Corbett administration will explore some of the other options suggested by Ms. Sebelius.

In discussing the benefits of the health care overhaul, Ms. Sebelius marveled at the story told Tuesday by Cathy Stoddart, a transplant nurse at Allegheny General and president of the SEIU chapter there representing nurses. Her family had to file for bankruptcy after medical bills for her son's heart condition overwhelmed them -- even though they had health insurance.

"I'm determined that no family will have to go through what our family went through," Ms. Stoddart said.

Ms. Stoddart said about 500 nurses, nurse's aides, home care workers and others -- most of them volunteers -- will canvass the region, knocking on doors and telling residents about the new health exchanges "because people may not know that they qualify."

They will concentrate on low-income neighborhoods, where they expect there will be a higher concentration of uninsured, but "we're trying to get the word out as broadly as possible."

Stories like the one about Ms. Stoddart's bankruptcy have convinced Ms. Sebelius of the law's virtues. Under the Affordable Care Act, there will be no more annual or lifetime coverage limits on health insurance policies, and there will also be hard caps on out-of-pocket expenses for those with health coverage.

"Nobody should lose their house because they get sick. Nobody should be terrified to take their kid to a doctor or to get a mammogram because they can't do anything about the results once they get them. Those days are coming to an end," she said.

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Bill Toland: or 412-263-2625. Steve Twedt: or 412-263-1963. The Associated Press contributed. First Published September 11, 2013 4:00 AM


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