Health and Human Services Secretary Sebelius made a first major stop on her tour to promote health care reform on the Daily Show with Jon Stewart Monday night. It was long on jargon and short on laughs as Stewart dug into the policy weeds, focusing on how health insurance exchanges will work and the balance of oversight between federal and state government.
Sebelius could have, but didn't, glow as Stewart asked about HHS's latest bulletin on essential health benefits, which gave states more flexibility to determine what a health insurance plan should include.
Sebelius argued, that the federal government still helps frame the benefits: Congress set 10 categories of benefits that must be covered. But “the flexibility should be at the state level,” she said.
“Isn’t that Mitt Romney’s argument?” Stewart asked. Romney has said his Massachusetts health care law isn't a model for the 2010 health reform legislation because what works for one state doesn’t necessarily work for another.
“Actually, the way the law was written in the first place is that states get to take the lead,” Sebelius said. “States can set up their own exchanges, around a set of rules, and insurance companies for the first time have to play by a set of rules.”
She said it was ironic that some states are expressing their opposition to health reform by saying they won't play at all. "That’s the only time the federal government steps in,” Sebelius said.
Stewart asked whether the exchanges will become “a sort of back door” to greater government involvement in health care, by decoupling insurance from employment and instead tying insurance to tax credits.
“I think what we’ll have is filling in the gaps of the private market,” Sebelius answered.
Sebelius also said that she doesn’t believe the Supreme Court will strike down the individual mandate. Even if it does, she said, “I think we keep going. We find ways to encourage people to become enrolled, and become insured.”