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Kathleen Sebelius

Kathleen Sebelius legacy discussion thread

by: desmoinesdem

Fri Apr 11, 2014 at 09:33:29 AM CDT

U.S. Health and Human Services Director Kathleen Sebelius is stepping down, news broke last night. Hours earlier, Sebelius told members of Congress that an estimated 7.5 million Americans had signed up for health insurance through the state and federal exchanges created under 2010 health care reform law. A statement from the HHS department hailed her "work on Head Start, to expanding mental health coverage, to advancing cutting-edge health care research and, of course, her unwavering leadership in implementing the Affordable Care Act."

Naturally, instant commentaries on Sebelius' departure have highlighted the disastrous rollout of the Healthcare.gov website. I thought she should have resigned last fall. Even though the technical failure wasn't entirely her fault, someone should have been held accountable. Igor Volsky took a more generous view, praising Sebelius' work with Republican governors on alternatives to Medicaid expansion. She also convinced some of them, including Iowa's Terry Branstad, to "form partnership health care exchanges in which the federal government and the state would share responsibilities in running the marketplaces."

All in all, I think Sebelius could have done the country more good by staying in Kansas. As governor, she could have continued to block new coal-fired power plants and veto lunatic bills coming out of the state legislature. Plenty of people could have done at least as well, if not a better job, running HHS and implementing the Affordable Care Act.

What do you think, Bleeding Heartland readers?

President Barack Obama will appoint Office of Management and Budget Director Sylvia Mathews Burwell to replace Sebelius. Juliet Eilperin and Amy Goldstein reported, "Although Burwell does not have an extensive background in health-care policy, she is known for her strong management skills and has experience in issues of poverty and global health issues from her time at the Bill and Melinda Gates Foundation. Moreover, she is popular on Capitol Hill. The Senate confirmed her as OMB director 96 to 0 almost exactly a year ago." Some Republicans are already praising her, and in any event, the 60-vote threshold for confirming presidential appointees no longer applies in the Senate.

Discuss :: (2 Comments)

Federal government approves most of Iowa's Medicaid expansion alternative

by: desmoinesdem

Tue Dec 10, 2013 at 18:39:21 PM CST

The U.S. Department of Health and Human Services has granted a waiver for Iowa's alternative to the Medicaid expansion foreseen under the 2010 health care reform law. Governor Terry Branstad signed the Iowa Health and Wellness Plan compromise into law in June, and state officials submitted a formal request for a waiver in August. Iowa elected officials from both parties as well as many non-profit organizations with a stake in the outcome had urged Health and Human Services to approve the plan.

However, Governor Terry Branstad may appeal today's decision, because federal officials rejected a provision he insisted on during negotiations with Democrats in the Iowa legislature.

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Health exchange website fiasco links and discussion thread (updated)

by: desmoinesdem

Mon Oct 21, 2013 at 15:09:47 PM CDT

Three weeks into the launch of exchanges where millions of Americans are supposed to shop for private health insurance, the federal Healthcare.gov website is still a disaster. At a White House press conference today, President Barack Obama promised a massive effort to fix the problems and highlighted other benefits of the 2010 Affordable Care Act.

After the jump I've posted news and analysis related to the botched rollout of the health insurance exchanges. Any comments related to the 2010 health care reform law are welcome in this thread. It's worth noting that Democrats in the Iowa legislature favored creating a state-run exchange, which would have eliminated the need for Iowans to purchase insurance through the screwed-up federal website. But Governor Terry Branstad insisted on a state-federal partnership, under which the federal government would administer the website for finding health insurance.

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New hope for Medicaid expansion in Iowa?

by: desmoinesdem

Mon May 20, 2013 at 17:29:00 PM CDT

When news broke last week of a tax compromise skewed toward business, I wondered why Senate Democrats would agree to pass that bill without progress toward Medicaid expansion, one of their top priorities. Governor Terry Branstad was saying legislators should adjourn after approving a budget, education reform and the tax deal, returning later this year for a special session on health insurance coverage for low-income Iowans. In my opinion, Democrats would be insane to give Republicans what they want on taxes now, hoping for Medicaid expansion later.

Today several signs point toward a possible deal on Medicaid coverage before the end of the legislative session.

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Latest Iowa Medicaid expansion news and discussion thread

by: desmoinesdem

Tue Mar 12, 2013 at 11:10:00 AM CDT

Expanding Medicaid in Iowa would add nearly $2.2 billion to the state's economy, create an estimated 2,362 jobs, and save state government about $1.6 billion, according to a new study. For now, Governor Terry Branstad is sticking to his alternative plan for covering some low-income Iowans, but Senator Tom Harkin predicted last week that federal officials will not approve a waiver for Branstad's approach.

Follow me after the jump for details on those stories and more about Medicaid in Iowa. I've also enclosed a moving personal statement State Senator Mary Jo Wilhelm delivered today about Iowans who can't afford health insurance.

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Branstad has no case against expanding Medicaid (updated)

by: desmoinesdem

Fri Feb 22, 2013 at 09:52:38 AM CST

Five years ago this week, I was hospitalized with an infection that might have become life-threatening or permanently debilitating had I not had health insurance coverage, which allowed me to receive a relatively early diagnosis. Every day in this country, uninsured people hunker down, hoping their health problem will go away without an expensive doctor's visit. That's one of many reasons studies have shown that expanding Medicaid saves lives.

Governor Terry Branstad sounds determined not to expand Medicaid, but none of his arguments can withstand scrutiny.

UPDATE: Branstad confirmed on February 23 that he will not agree to expand Medicaid. Added details and other related news below.

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Another Obama cabinet discussion thread

by: desmoinesdem

Thu Jan 10, 2013 at 18:12:40 PM CST

President Barack Obama announced today that his Chief of Staff Jack Lew is his pick to replace Timothy Geithner as Treasury secretary. I have low expectations, since Lew has been a "central player in two failed attempts at a grand bargain on deficit reduction with House Republicans." The "grand bargain" would have paired token tax hikes on the wealthy with significant benefit cuts for middle-class and low-income Americans. Republican Senator Jeff Sessions of Alabama did not rule out filibustering Lew's nomination.

I was surprised to hear that Hilda Solis is leaving as Labor secretary. She was one of Obama's better cabinet picks, but White House officials have undermined her on several issues, notably efforts to regulate child labor at agricultural facilities. Brad Plumer posted a good summary of Solis' record.

According to the White House, the following cabinet members will stay on for now: Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius, and Veterans Affairs Secretary Eric Shinseki. I'm concerned that Transportation Secretary Ray LaHood was not on that list.

Any comments about Obama's cabinet and/or the "embarrassing as hell" lack of diversity in the president's "inner circle" are welcome in this thread.

UPDATE: I did not realize that the Commerce secretary position has been vacant for almost six months.

Discuss :: (3 Comments)

Health care exchange and Medicaid expansion news roundup

by: desmoinesdem

Mon Dec 17, 2012 at 09:58:10 AM CST

Last week Iowa Governor Terry Branstad confirmed that Iowa will pursue a "partnership" health insurance exchange next year, rather than setting up its own insurance exchange for implementing the 2010 health care reform law, or letting the federal government set up an exchange for Iowa.

In addition, the governor again signaled that he is against the now-optional Medicaid expansion for states, because he believes it would become too expensive for Iowa in the future.

Links and recent news about health care reform in Iowa are after the jump.

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Feds to offer Branstad chance to save face while expanding Medicaid

by: desmoinesdem

Mon Sep 17, 2012 at 19:45:00 PM CDT

U.S. Health and Human Services Secretary Kathleen Sebelius, a former governor of Kansas, made clear last week that the Obama administration will work with governors who are reluctant to expand Medicaid eligibility in their states.
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Sebelius warns insurers against excluding sick kids

by: desmoinesdem

Tue Mar 30, 2010 at 10:00:41 AM CDT

Health and Human Services Secretary Kathleen Sebelius wrote to the head of the insurance industry's lobbying arm yesterday warning against efforts to continue to deny coverage to children with pre-existing conditions. Excerpt from the letter, which you can download as a pdf file at Greg Sargent's blog:

Health insurance reform is designed to prevent any child from being denied coverage because he or she has a pre-existing condition. Leaders in Congress have reaffirmed this in recent days in the attached statement. To ensure that there is no ambiguity on this point, I am preparing to issue regulations in the weeks ahead ensuring that the term "pre-existing condition exclusion" applies to both a child's access to a plan and to his or her benefits once he or she is in the plan. These regulations will further confirm that beginning in September, 2010:

*Children with pre-existing conditions may not be denied access to their parents' health insurance plan;

*Insurance companies will no longer be allowed to insure a child, but exclude treatments for that child's pre-existing condition.

I urge you to share this information with your members and to help ensure that they cease any attempt to deny coverage to some of the youngest and most vulnerable Americans.

A spokesperson for House Speaker Nancy Pelosi sent Sargent the following statement:

The intent of Congress to end discrimination against children was crystal clear, and as the House chairs said last week, the fact that insurance companies would even try to deny children coverage exemplifies why the health reform legislation was so vital. Secretary Sebelius isn't going to let insurance companies discriminate against children, and no one in the industry should think otherwise.

Let's hope this works. I wouldn't be surprised to see insurance companies challenge the new regulations in court. They must have been counting on that loophole to save them money during the next few years.

UPDATE: David Dayen is probably right about the insurance companies' motives here:

You can pretty much figure out AHIP's game here. With no restrictions on cost until 2014, the industry can raise their premium prices almost at will. Even the bad publicity suffered from that 39% rate hike of Anthem Blue Cross [of California] plan has not stopped that scheduled increase from taking effect in May. And when outrage is expressed by families facing double-digit rate hikes, AHIP will clear their throats and blame the pre-existing condition exclusion for children, forcing the poor insurance companies to take on a sicker risk pool and raise prices to survive.

Except covering kids is fairly cheap to begin with. And the universe of kids with a pre-existing condition who aren't covered through SCHIP, Medicaid, or an employer plan is extremely small. So by making a big issue of this, AHIP potentially sets up large rate hikes in the 2010-2014 period that aren't at all justified.

Discuss :: (0 Comments)

Year in review: national politics in 2009 (part 2)

by: desmoinesdem

Thu Jan 07, 2010 at 14:56:38 PM CST

Following up on the diary I posted this morning, this post compiles links to Bleeding Heartland's coverage of national politics from July through December 2009. Health care reform was again the number one topic. I wish there had been a happy ending.
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Year in review: national politics in 2009 (part 1)

by: desmoinesdem

Thu Jan 07, 2010 at 07:52:32 AM CST

It took me a week longer than I anticipated, but I finally finished compiling links to Bleeding Heartland's coverage from last year. This post and part 2, coming later today, include stories on national politics, mostly relating to Congress and Barack Obama's administration. Diaries reviewing Iowa politics in 2009 will come soon.

One thing struck me while compiling this post: on all of the House bills I covered here during 2009, Democrats Leonard Boswell, Bruce Braley and Dave Loebsack voted the same way. That was a big change from 2007 and 2008, when Blue Dog Boswell voted with Republicans and against the majority of the Democratic caucus on many key bills.

No federal policy issue inspired more posts last year than health care reform. Rereading my earlier, guardedly hopeful pieces was depressing in light of the mess the health care reform bill has become. I was never optimistic about getting a strong public health insurance option through Congress, but I thought we had a chance to pass a very good bill. If I had anticipated the magnitude of the Democratic sellout on so many aspects of reform in addition to the public option, I wouldn't have spent so many hours writing about this issue. I can't say I wasn't warned (and warned), though.

Links to stories from January through June 2009 are after the jump. Any thoughts about last year's political events are welcome in this thread.

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Shorter Sebelius: We surrender

by: desmoinesdem

Sun Aug 16, 2009 at 18:00:00 PM CDT

UPDATE: Some White House officials told Marc Ambinder that Sebelius misspoke, or the media misinterpreted her remarks. I would prefer a clear statement from the president.

Health and Human Services Secretary Kathleen Sebelius waved the white flag on Sunday:

Sebelius said the White House would be open to co-ops instead of a government-run public option, a sign Democrats want a compromise so they can declare a victory on the must-win showdown.

"I think there will be a competitor to private insurers," she said. "That's really the essential part, is you don't turn over the whole new marketplace to private insurance companies and trust them to do the right thing. We need some choices, we need some competition."

Sen. Richard Shelby, R-Ala., said co-ops might be a politically acceptable alternative as "a step away from the government takeover of the health care system" that the GOP has assailed.

(continues after the jump)

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The health care status quo is not good enough

by: desmoinesdem

Sat Jun 27, 2009 at 17:20:42 PM CDT

Health and Human Services Secretary Kathleen Sebelius issued reports on Friday detailing the problems with the "health care status quo" across the country. You can find the reports at HealthReform.gov. The report for Iowa is here, and I've also posted it after the jump. Among other things, it shows the percent increase in family health insurance premiums since 2000 and the percentage of uninsured Iowans.

A couple of points jumped out at me:

• Choice of health insurance is limited in Iowa. Wellmark BC and BS alone constitutes 71 percent of the health insurance market share in Iowa, with the top two insurance providers accounting for 80 percent.11

Iowa is not unusual in this regard. Most insurance markets in the United States are dominated by one or two companies. My family's Wellmark premiums went up 10 percent this year alone. Speaking of which, the annual salary of Wellmark's CEO has "nearly doubled" in the past five years to about $2.5 million.

• Choice is even more limited for people with pre-existing conditions. In Iowa, premiums can vary, within limits, based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.

I know a family in Des Moines who were unable to purchase health insurance at any price because the mother has a thyroid condition. They are now covered through the father's employer, but if he loses his job they will have no health insurance options.

Two more reasons why we cannot settle for health care reform without a public option, or with a fake public option. I was glad to see several House Democratic caucuses affirm that they will fight any health care bill lacking "a real and robust public option that lives up to our criteria".

Click "there's more" to read the whole report, with supporting footnotes.

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The dangers of a fake public health insurance option

by: desmoinesdem

Thu Jun 18, 2009 at 19:31:37 PM CDT

The White House and key Democratic senators, including Iowa's Tom Harkin, appear to be walking into a trap for the sake of bipartisan agreement on health care in the Senate.

There is growing support for a fake "public option," as opposed to a government health insurance plan that would compete directly with private insurance companies.

If Congress passes this kind of deal and President Barack Obama signs it, we will get a enormously expensive non-solution to an enormous problem, and Democrats will pay the political price.

After the jump I'll explain why political hacks as well as policy wonks should refuse the latest efforts to derail the public option.  

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What you can do to support the public option

by: desmoinesdem

Thu Jun 18, 2009 at 08:05:37 AM CDT

Iowa State Senator Jack Hatch was in Washington yesterday to chair the first meeting of a working group on health care. According to a White House press release,

State Legislators for Health Reform includes leaders from across the country who will educate their communities on the need for health reform this year.  The legislators will host public events, author opinion pieces in local publications, and use their established networks to organize constituents in support of health reform.

The Iowa Senate Democrats issued a statement from Hatch, who said the state legislators told Health and Human Services Secretary Kathleen Sebelius that "state-level health care reforms can only go so far." He added that Sebelius

"stressed the need to expand choices in the health insurance market is essential.  Increased competition will lower costs and improve patient care.

"That's why we all agreed that Americans must have a public health insurance option and now is the time to speak up."

A public option that makes health insurance more accessible and affordable for adults is also likely to improve the health of children. Kevin Concannon of the Iowa Department of Human Services explained why in his contribution to the Reforming States Group's May 2009 Healthy States/Healthy Nation report:

Ultimately, to achieve better health care access and better health status for children, the United States needs to cover parents as an essential, linked strategy for children. If parents have health insurance, they will better utilize the health care systems available to their children.

If you believe that real health care reform requires a public option for health insurance, you have two new and easy ways to do something about it. Neither will take more than a minute or two of your time.

Details are after the jump.

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Late-term abortion provider murdered in church

by: desmoinesdem

Sun May 31, 2009 at 14:42:59 PM CDT

An assailant shot and killed Dr. George Tiller at a church in Wichita, Kansas this morning. Tiller has long been demonized by the anti-choice movement because he performs late-term abortions. He was shot in 1993 and has faced numerous threats, and his clinic has been bombed and vandalized. The Wichita Eagle has background here and is updating the story. (Note: police arrested a 51-year-old male suspect about three hours after the shooting.)

Daily Kos user wiscmass discusses other violent attacks against abortion providers here. As wiscmass notes, every murder or assault is a deterrent to medical professionals considering whether to provide abortion services. By intimidating doctors, anti-choice activists can restrict access to abortion where legal and political methods have failed. I would add that even non-violent methods of intimidation can be effective. For instance, the Sioux City medical community has made clear hospital privileges will be denied to any local doctor who performs abortions at Planned Parenthood of Greater Iowa's clinic there.

Tiller was not only serving women in Kansas. Many states, including Iowa, lack any clinic where women with a compelling medical reason can get a late-term abortion. (Contrary to propaganda you may have heard, healthy women with healthy pregnancies can't just walk into Tiller's clinic and get an abortion in the third trimester.) I have no idea where these women will go now.

Incidentally, Tiller's donations to Kansas Governor Kathleen Sebelius and her political action committee prompted 31 Senate Republicans to vote against confirming Sebelius as Health and Human Services secretary in April.

Cecile Richards, leader of Planned Parenthood Federation of America, told a story about Sebelius during a recent speech at Planned Parenthood of Greater Iowa's 75th anniversary celebration. Richards recalled a noisy group of protesters with graphic signs outside a Planned Parenthood event in Kansas. Everyone who attended the event, including then-Governor Sebelius, had to walk through the group of protesters. During her speech that night, Sebelius said she was glad everyone had to face those protesters, because it gave them a sense of what women in Kansas go through every day just trying to access reproductive health care.

Unfortunately, Tiller's murder reminds us that standing up for reproductive rights in this country sometimes means putting your life in danger. I echo wiscmass in urging pro-choice Americans to support the organizations that are on the front lines in this battle.

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Senate finally confirms Sebelius; Grassley votes no

by: desmoinesdem

Tue Apr 28, 2009 at 19:20:40 PM CDT

President Barack Obama's cabinet is complete just in time for his 100th day in office, now that the Senate has confirmed Kansas Governor Kathleen Sebelius for Health and Human Services secretary by a vote of 65 to 31. Senator Chuck Grassley joined most of his Republican colleagues in voting no, citing her ties to George Tiller, a Kansas doctor who performs late-term abortions.

When Obama picked Sebelius I didn't expect her confirmation to become controversial, since she is a popular Democratic governor in a conservative state. (Both of the Republican senators representing Kansas voted to confirm Sebelius.) However, anti-abortion groups have been fighting the nomination because when asked how much money Dr. Tiller had donated to her, Sebelius initially reported only his contributions to her campaign funds and not his contributions to her political action committee.

For a time Republicans threatened to filibuster Sebelius's nomination, but they never appeared to have the votes to support a filibuster. Grassley indicated last week that although he opposed Sebelius, he would not have backed a filibuster of her nomination.

Republicans did manage to hold up her confirmation vote for a while. The silver lining behind that obstructionist cloud was that Sebelius remained governor long enough to veto a bill that would have paved the way for two huge coal-burning power plants in Kansas.

Sebelius's 31 no votes in the Senate make her the second most-controversial Obama cabinet member. Treasury Secretary Timothy Geithner was opposed by 34 senators, including both Grassley and Tom Harkin.

Earlier this year it seemed that Republican opposition would be strongest to Obama's choice for attorney general, but Eric Holder drew only 21 no votes in the Senate. Grassley voted to confirm Holder despite some doubts, saying he was influenced by his (then Republican) colleague Arlen Specter.

Grassley also voted for the fourth most controversial Obama nominee, Labor Secretary Hilda Solis. Seventeen Republican senators voted against her confirmation.

Discuss :: (0 Comments)

Chuck Grassley Abuses the Constitution by HIS definition

by: Elise

Thu Apr 23, 2009 at 22:13:30 PM CDT

(Typical Republican hypocrisy on filibusters. - promoted by desmoinesdem)

March 14, 2005 - The New Yorker publishes an article, NUKE ‘EM in which Senator Chuck Grassley is quoted, discussing the purpose of the filibuster:

“Filibusters are designed so that the minority can bring about compromise on legislation,” Senator Charles Grassley, an Iowa Republican, told Toobin. “But you can’t compromise a Presidential nomination. It’s yes or no. So filibusters on nominations are an abuse of our function under the Constitution to advise and consent.


My husband called Grassley's office today - he read this quote to the aide and asked, "Does Senator Grassley stand by this statement?"
There's More... :: (8 Comments, 591 words in story)

Pros and cons of Sebelius as Health and Human Services Secretary

by: desmoinesdem

Mon Mar 02, 2009 at 21:47:36 PM CST

President Barack Obama formally announced on Monday that he is nominating Kathleen Sebelius to serve as Health and Human Services Secretary in his cabinet. She should be confirmed with little trouble, as various Republicans have already praised her nomination.

After the jump I've posted my initial thoughts on the pluses and minuses of this appointment.

There's More... :: (1 Comments, 844 words in story)
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