Kathleen Sebelius, the secretary of Health & Human Services (HHS), has spearheaded the administration’s reform effort. At her urging, health insurers have agreed to continue coverage for many young adults ahead of the provision’s start date.
WebMD spoke to Sebelius about the young adult coverage and her work on reform.
Q: Why is the administration pushing up the timetable to allow children to remain on their parents’ health plan until age 26?
A: For a lot of the graduates this year, there would be a gap in coverage. Kids would graduate in May, lose their family insurance coverage, and then have the opportunity to be re-insured in September [when the reform provision would begin], and that seemed to be an unnecessary glitch.
So I reached out to the major insurance companies, and the good news is we have about 65 companies, as well as large employers, stepping up and saying they agree that gap makes no sense. And they’ll actually open up the plans early to try to make sure that kids who have coverage right now can continue that coverage.
There clearly are people who have lost their coverage who are eligible after September, and there will be an open enrollment period so those young adults can re-enroll in their parents’ plans. But for the kids who are currently covered, it just seemed that this might be a great way to work together and make sure there wasn’t several months’ gap in insurance coverage, and all the costs that go with disenrolling somebody and then trying to reach out and re-enroll them.
Q: You’ve said this was an issue in your own family, correct?
A: Absolutely. I have two sons -- one finished college in 2003 and one finished in 2006, and neither of them went into jobs where there was health insurance provided. We found ourselves doing what a lot of families do, which is celebrating graduation but at the same time trying to figure out what kind of insurance coverage we could get for our kids, because they were no longer eligible for family coverage. So I know personally what kind of relief this is.
And in both of those graduating years for my kids, the economy was actually in better shape than it is now. A lot of the young 20s either don’t have jobs at all, or if they have jobs, those jobs are less likely to have health benefits, so I think this is an additional piece of stability for a lot of American families.
Q: How many people will this help?
A: We think there are about 1.2 million young Americans who may qualify for this benefit. I think the feedback that we have gotten so far is enormously positive from families and young adults.
Q: As secretary, you have fought against health insurers on premium increases, policy rescissions, and pre-existing condition exclusions. Do you view this role as similar to your past work as Kansas insurance commissioner?
A: Well, it’s familiar, and that’s good news. I kind of know the ropes. As insurance commissioner I worked at the national level, and worked with a lot of the major insurers. But the way this bill is set up, it’s a very state-friendly bill. So we still assume that states are the best place for regulation, and we at HHS can stand behind the states. We think the states are the best place to run a high-risk pool or to set up a state [insurance] exchange. But in the event they don’t want to do that, the folks at HHS will work on behalf of consumers in that state. I get to work with a lot of my old colleagues, and I’m very familiar with the kind of work they’re doing and the kind of regulatory oversight that’s so important to protect people against what may be egregious activities [by] insurance companies.
Q: Why isn’t health care reform more popular in the public opinion polls?
A: There’s still a lot of confusion about what actually the law does and what it doesn’t do. One of the challenges we have, along with implementation, is to explain to people a lot of what they heard about -- that government was going to take over your health plan, or there would be some sort of a death panel -- a whole variety of scare tactics and misinformation that were intentionally put out into the public and driven with about $200 million worth of ads. People have a lot of misconceptions.
But what I find is that the more they learn about the law -- about the fact it’s really returning some authority back to consumers, helping them get some control over their own health decisions, giving people choices they didn’t have, using the kind of clout of our office to put together helpful information and oversight -- the more positive they feel about the bill.
Q: What’s the one thing in the reform law that you wish more Americans knew about?
A: One of the really exciting features that isn’t an immediate payoff, but I think may have the best long-term bang for our buck, is the real shift we’re making from what we have now as a sickness care system into a real health care system. A lot of benefits, a lot of the framework is getting everybody a health home, making sure that preventive care doesn’t have financial barriers. Trying to intervene early, get more primary care docs, more nurse practitioners, more people who work hard at keeping their patients healthy [rather] than waiting till they get to hospital and treating them when they’re sick.
We spend a whole lot of money compared with most countries around the world, and our health results are pretty mediocre. I’m a big believer that if we can refigure our health incentives, look at quality outcomes, and hopefully get peoplein healthiercondition and keep them there, that overall we’ll have much higher quality at a lower cost and better results.
Q: Is there one thing that everyone in the country could do to be healthier?
Q: What role do online health services like WebMD play in educating consumers?
A: I think WebMD is a huge educational tool and actually I’m looking forward to having a much more robust conversation with [WebMD] about ways we can help populate your web site with lots of information about this bill and work together to get information tools out to the American public. For a lot of people, the health system is very difficult to navigate, very complicated to try to figure out what are the choices, how to make cost-effective decisions. You have a great audience who is eager to get information. We’re eager to find ways to get information out to people, so we can do a lot of good work together.
Q: What personally is your biggest health challenge?
A: Sleep. I need a little more.