Sebelius Says Obama Wants Health Overhaul Cost 'Within the Bounds of Reason'

By JANE NORMAN, CQ HealthBeat Associate Editor
Originally published in CQ HealtBeat
June 17, 2009

Health and Human Services Secretary Kathleen Sebelius on Wednesday reiterated the administration's determination to enact a health overhaul that does not add to the deficit -- even as congressional committees struggled with the very question of how to provide expanded access and coverage at a politically acceptable cost.

The lesson to be learned from a Massachusetts health overhaul that has provided nearly universal coverage is that cost has to be considered as much as expanded access, Sebelius said in remarks to the Democratic Leadership Council. "We have to make sure the cost is within the bounds of reason, that we don't bankrupt our families and drive our businesses into a less competitive state," Sebelius said.

As Sebelius spoke, Democrats on the Senate Health, Education, Labor and Pensions Committee were fielding harsh criticism from Republicans about a Congressional Budget Office estimate that the committee's initial overhaul proposal, which is not yet complete, will cost $1 trillion over 10 years but reduce the number of uninsured by just 16 million. Meanwhile, Democrats on the Senate Finance Committee postponed markup of that panel's overhaul bill in order to continue negotiations with Republicans and look for ways to keep the total cost below $1 trillion over 10 years.

"The president is very serious for the notion that as we look at a health reform bill being passed, we shouldn't add to the deficit, which is currently alarmingly large and continuing to grow," said Sebelius. She cited President Obama's proposals to reduce Medicare and Medicaid spending by some $622 billion over 10 years to pay for the health overhaul, in addition to raising revenue through limiting tax deductions for the nation's wealthiest earners, for a total of $900 billion.

"There are a number of options for funding health reform and members of Congress are currently engaged in a robust debate about which ones make the most sense, but I think what's most important is to organize around paying for a 10-year plan as we move forward," she said.

Sebelius also sought to appease advocates of single-payer insurance plans, saying that if Obama was able to start from scratch he wouldn't choose the current system. But "right now we have the system that we have" and 180 million Americans rely on employer-based group coverage and like the plans they have, she said.

"Dismantling that current infrastructure in order to reach a new goal is not the most productive way to go about this," she said. "I'm a believer that competition is a good way to get there. . .a competitive marketplace is often much better than heavy-handed regulation." That's why Obama supports health exchanges, marketplaces for insurance plans that would be included in most of the major Democratic plans, she said.

Obama also continues to support a public option as part of the overhaul, she said. Both Sebelius and Nancy-Ann DeParle, White House director of health care reform, were set to meet Wednesday afternoon with a group of state legislators called the Progressive States Network who support a public option as part of any overhaul plan. The lawmakers said at a press conference that they will bring along a letter signed by 700 legislators calling for a public health insurance plan as part of comprehensive health reform.