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Health and Human Services Secretary Kathleen Sebelius defended the Obama administration's ruling that religious-affiliated institutions must include birth control as part of their health insurance plans.
Testifying before the Senate Finance Committee Wednesday, Health and Human Services Secretary Kathleen Sebelius defended the Obama administration’s ruling that religious-affiliated institutions must include birth control as part of their health insurance plans.
On Friday the administration announced a modification that allows religiously-affiliated employers to shift contraceptive costs to insurance companies. For some Democrats, such as Sen. Ben Nelson of Nebraska, President Obama still hasn’t settled the question of how to treat the employers who self-insure and do not contract with an insurance company to cover their employees.
Health and Human Services Secretary Kathleen Sebelius comments on the latest announcement regarding the details of the White House's contraception rule.
But Obama seems to have quieted at least some dissident Democrats by issuing last week's adjustment. And that may be all he needs to do in order to defuse the political problem in his own party that the HHS contraceptive mandate created.
Related: Obama revamps contraceptive policy
With the election-year furor over contraceptives seemingly abating, Sebelius and Obama face a far larger imponderable: whether they will be able to implement the highly complex health care law -- even if it survives a Supreme Court decision on its constitutionality, which will come this June.
Three days of oral arguments before the high court begin March 26.
Meanwhile, Sebelius and her department are working with state governments to set up the new state-based insurance marketplaces, or “exchanges” in which uninsured American will be able to buy coverage, beginning in 2014.
According to the National Conference of State Legislatures, at least 22 states have legislation pending to establish a health insurance exchange. But some states are refusing to set them up, and others have joined the litigation to overturn the health care law.
“Right now I think it’s impossible to tell you exactly how many states will have a state-based exchange” Sebelius told Finance Committee Chairman Max Baucus, D- Mont., “What I am confident about,” she said, is the states will begin enrolling individuals in fall of 2013 so the exchanges can be operating by 2014.
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One Finance Committee Democrat, Sen. Jeff Bingaman of New Mexico, told Sebelius he was worried about states setting up information technology systems to run their exchanges that will be unable to communicate with each other and unable to provide data for the HHS. Bingaman said he was concerned about “everyone inventing the wheel in every state in the union.”
Sebelius replied, “Your concern is well-placed and well-founded” and described steps HHS is taking to ensure IT compatibility and more uniformity across state lines.
Another Democrat on the committee, Sen. Bob Menendez of New Jersey, illustrated the complexity of the 2010 law when he complained to Sebelius about three problems that he said HHS was slow in resolving: defining behavioral treatment to cover treatments for autism (New Jersey has the highest incidence of autism of any state), a program for treating post-partum depression for mothers, and a waiver for the state’s Medicaid program from certain federal regulations.
Menendez told Sebelius it was “frustrating” to be kept in the dark about the Medicaid waiver because the process “goes on behind closed doors without public notice and certainly without public input.”
After the hearing Menendez said of his three concerns: “I am waiting for them to act upon them and I am concerned in some ways about how they are acting upon them,” he said. Sebelius’s answers “are not totally satisfactory.”
And not surprisingly, Republicans continued their strategy of predicting failure for Obama’s health care overhaul, which every Republican senator voted against in 2010.
Sen. John Cornyn, R- Texas, told Sebelius that “the administration has grossly underestimated the number of employers who will drop their employees from coverage” and “the costs will explode” for the health care exchanges. But Sebelius cited the insurance overhaul signed into law by former Massachusetts Gov. Mitt Romney as evidence that when insurance buying exchanges are set up, employers do not drop workers’ coverage.
Sen. Orrin Hatch, R-Utah, the ranking Republican on the Finance Committee, told reporters after the Sebelius hearing: “She’s pretty well admitted that they’re way behind on their regulations, they’re way behind on implementation, they’re way behind on exchanges.”
The most significant and intricate features of the law, such as the exchanges and the requirement for virtually all Americans to buy insurance, if they’re not already covered, will take effect in 2014.
“That bill is going to be almost impossible to implement and I think they are starting to realize that,” Hatch said.