Editor’s note: Msnbc’s Ari Melber and Irin Carmon both spoke separately to former Secretary of Health and Human Services Kathleen Sebelius Thursday, and she offered up her thoughts on the Supreme Court’s Obamacare ruling to both reporters.
More than any other Obama administration official, former Secretary of Health and Human Services Kathleen Sebelius bore responsibility for the Affordable Care Act – for better and sometimes for worse, as she was broadly criticized for the initial rocky rollout of the federal exchange website. She served from 2009 to 2014, during which the Supreme Court upheld the signature law the first time around. On Thursday, msnbc caught up with Sebelius for her take on the Supreme Court saving the Affordable Act Act a second time.
What’s your reaction to the Supreme Court’s decision today?
I think it’s a very strong majority decision that insures the law can continue to function. I know there are probably 6.4 million people who are thrilled that their health care continues. And we have two more open enrollment periods until President Obama leaves office. … I think the work that has begun around delivery system reform, improving health care, lowering costs for everybody can really be accelerated since a lot of work won’t have to go into recreating the exchanges.
How has the fact that the administration has had to play so much defense on the law affected its progress?
A lot of people still are confused about whether the law is going to stay in place, whether it’s going to be around. It has been five years of votes in Congress to repeal this bill, with continued battles on all fronts. I’m hopeful that now that we have the second Supreme Court decision affirming the ACA, that it’s time to move on. … I talk to people every day whose lives have been improved, whose family situations are better, who have a new job or a new lease on life thanks to this act, and those numbers are going up by the moment. So hopefully we can all focus on the future.
In his opinion, Chief Justice John Roberts says the bill “contains more than a few examples of inartful drafting.” Anything you wish had been done differently?
This was a bill that actually had five different committee authors, three in the House and three in the Senate. It was debated and amended in each of those forums. I think people who suggest somehow that this was done in the dark of the night and no one knew what was in the law are just dead wrong. Unfortunately, there was not necessarily perfect draftsmanship at every point along the way. … I think the very good news is that the court, six justices who ruled and joined the majority opinion, saw that this was a law designed to improve the health insurance market. Never was there any intent to have geography be a determinant of whether or not you got coverage. Everything in the law moved away from geographic bias and into a national framework.
Justice Scalia said today the ruling reflects the fact that Obamacare has become sort of a favorite or special protected law, treated differently by this court – essentially by Roberts and the Democratic appointees – than other laws. What do you make of that concern of the justice?
well I don’t pretend to be a Supreme Court scholar, but I do think it reflects a certain bitterness about the way justices view the law. Everything I knew from legal scholars said, any interpretation other than the one that was found today would be very unusual. Based on precedent, based on congressional intent, based on the reading in full of the law and the way it was interpreted. I don’t find this unusual or protected, I think it fits very well with court precedent. And it isn’t just Justice Roberts, Justice Kennedy also joined in on the 6-3 majority.
President Obama worked so much on this law. When’s the last time you spoke with him or his team and got a sense of where their heads are at? And do you feel now –as they have said, as the president was reflecting today – that the period of dispute over the legitimacy and legality of this law is over?
Well I spoke to folks this morning, so I have a pretty good sense of where their heads are. I think there’s been a focus from the outset saying, were going to move forward. We’re continuing to move forward. But I can’t control the politics of the Republicans in Congress who want to keep replaying like Groundhog Day, re-ligate this topic. But I think there’s no question that the American people have moved on. … So hopefully the politicians will actually listen to their constituents and say let’s move on.
I know it was a separate legal question, but do you think now that the law is even more solidified, that more governors will begin accepting the Medicaid expansion?
I find it really baffling that we still have 20 states that have not yet taken advantage of what is the most generous federal state cost-sharing measure ever offered. 2016 is the last calendar year that 100% federal funding is available for newly insured Medicaid beneficiaries. But even in 2017 and beyond, there are very generous federal subsidies that match states by at least 90% or greater. I think it is a tragedy that we have a situation where there are still people in this country who are too poor to afford health insurance and can’t get any help based on a decision made by their governor and their state legislators. And it makes no sense to the economies of those states when over and over again, studies have shown jobs will increase and hospitals will be more stable [with Medicaid expansion].
So how will you celebrate?
I’m about to get on a plane to the Aspen Ideas Festival’s Spotlight on Health, and we are going to commemorate 50 years of Medicaid and Medicare. I think it will help to think about how, 50 years from now, people will be celebrating this step forward in the United States. That feels pretty good.