Sunday, July 13, 2014

FACT CHECK: A Sebelius dodge at hearing

October 30. 2013 10:36PM
Associated Press

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(AP) Here's what some Republicans want to know: If Health and Human Services Secretary Kathleen Sebelius thinks the new health insurance marketplace is going to be so great, why doesn't she get her own coverage from it?

As a Medicare beneficiary, she can't.

But her response to Republicans who pressed her Wednesday to sign up under a health insurance exchange was problematic. She said that because she's part of the federal employee health plan, she's not eligible to switch to the exchanges.

In fact, Americans who have workplace health insurance, as most with coverage do, can drop it in favor of individual policies offered by the exchanges. But doing so would not make financial sense for most.

A look at the back and forth at a House hearing, with underlying facts:

REP. CORY GARDNER, R-Colo.: "You're in charge of this law, correct? Why aren't you in the exchange?"

SEBELIUS: "Because I'm part of the federal employee health benefit plan. ... I'm not eligible for the exchange."

GARDNER: "You can decide to drop your coverage of your employer. You have the choice to decide not to choose ..."

SEBELIUS: "Not true, sir."

GARDNER: "I would encourage you to be just like the American people and enter the exchange and agree to find a way ..."

SEBELIUS: "It's illegal."

GOP Rep. Billy Long of Missouri also tried.

LONG: "You're architect of the whole program and you won't go into it with the rest of the American public."

SEBELIUS: "I did not say that, sir. I think it's illegal for me to."

LONG: "If you can, will you?"

SEBELIUS: "I will take a look at it."



It would be financially nonsensical for most with federal employee health insurance to step away from it in favor of an individual policy in the exchange. Doing so would mean losing the employer contribution to the health plan. It's also unlikely they would qualify for subsidized coverage available to many who seek insurance in the exchanges because they don't have access to workplace coverage.

But Sebelius' point that she can't do it because her federal employee insurance disqualifies her doesn't hold up.

What does block her from enrolling in an exchange is her status as a Medicare beneficiary, which she did not mention at the hearing. Plans offered by the exchanges cannot be sold to people on Medicare, and her department said in a statement that "the secretary is a Medicare enrollee."

Gardner told the hearing his family chose to have a private policy in Colorado "so we could be in the same boat as every one of my constituents."

But individual private policies are not the norm. Employer-based group coverage is. In that sense, Sebelius is already "just like the American people," as Gardner implored her to become.

Associated Press

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