Just a few days ago, Secretary of Health and Human Services Kathleen Sebelius announced her plans to resign from her post. President Obama gave her accolades, Congressional Republicans cheered for her departure and many Americans paused with one question in their head “What happens next?”
Primarily recognized for her role of being the executive in charge of the rollout of the Affordable Care Act, Sebelius had been in the realm of scrutiny during the tumultuous process of implementing the law. The law began on the wrong foot, with Congressional Republicans decrying the bill as unconstitutional, despite the fact that some of their caucus voted for the bill in the Senate. From there, the bill faced a court challenge, which eventually was resolved when the Supreme Court deemed that most of the law was indeed Constitutional. Fast forward to October of 2013 and the public eye shifted to Sebelius and the failure of the Healthcare.gov website. Many criticized Sebelius’s lack of oversight, and many called for her resignation. As we are learning from some new reports, it appears that she intended to resign following the website debacle. Yet, President Obama asked her to stay on. My only hunch is that it would be even worse had a change in personnel occurred midway through the rollout of open enrollment.
As enrollment numbers slowly crawled up, critics began to declare preemptively that the law had failed and the calls for Sebelius’s resignation grew louder and more numerous. Skepticism amongst Democrats grew, as the goal of 7 million enrollees appeared to be out of reach. Some were hoping for 6 million, others were anticipating less than that. Even at the end of February, there were barely over 4 million enrollees through the exchanges. At the end of March though, critics and proponents of the law alike were stunned to see the final number of enrollees be 7.1 million. A sigh of relief hit the Administration as they realized that the law was able to sustain its massive health care exchange, and that the law would most likely avoid repeal. But as we turn the page and begin the new chapter of the Affordable Care Act, Sebelius will no longer be the center of attention. Here’s what this means for the law:
1. The law has survived- Sebelius was unpopular amongst all of the Republican Congressional Caucus, indicating any sort of reform to the law to be dead on arrival. With the departure of Sebelius, it is difficult for Republicans to base their argument solely on her job performance. Perhaps, on the recommendation of Sylvia Mathews Burwell (Sebelius’s successor), reforms can be made to the law instead of simply arguing for repeal or no repeal.
2. The law can be fixed- As I had eluded to above, Sebelius’s recommendations were disregarded almost immediately, without much analysis of the ideas. The law’s debate is shifting from repeal to reform, and now we will see both sides propose legislation to amend the law in order to address some of the anomalies in the law. A poll from the Kaiser foundation in March indicated that a majority of Americans support keeping the law and making changes to it.
3. The 2014 Map has changed- The GOP planned to only discuss the failures of the ACA for their strategy this election season. But now Sebelius is gone, and the law appears to be doing well. Democrats have already announced their plans to seek legislation to reform the law. If Republicans only tout the awful website rollout, which has since been fixed, and blame an individual who has resigned, the public may not be persuaded to vote Republican in 2014. In fact, if current trends continue, the GOP could become the “Party of No” once more, rejecting any amendment to the law offered by Democrats.
Sebelius had her ups and downs as Secretary of HHS. She was a moderate Democrat who was viewed favorably by both parties when initially nominated. Additionally, she was able to take the criticism of everyone who was opposed to the law. While there were times she was unruly, and sometimes disorganized, it would be fair to say she never dropped the ball and avoided all of the blame. But as a whole, she is politically toxic. Reform couldn’t be done, and her clout on the Hill is basically nonexistent. Her resignation indicates an awareness of this fact, coupled with a chaotic rollout of comprehensive healthcare reform. Now that Ms. Sebelius has moved on, reform of the law can take place. The law will face challenges ahead, but what is clear is that the Affordable Care Act is here to stay, and will be taking a new, hopefully less chaotic path than the one previously traveled.