Health and Human Services Secretary Kathleen Sebelius told several hundred legislators and state health officers Monday that resistance to the 2010 health care overhaul should end, and that they can play a role in implementing the still hotly debated act.
“This is no longer a political debate; this is what we call the law,” Sebelius told a group that includes Democrats and Republicans, elected officials, political appointees and bureaucrats. “It was passed and signed three years ago. It was upheld by the Supreme Court a year ago. The president was re-elected. This is the law of the land.”
Transportation Secretary Anthony Foxx told a separate session of the National Conference of State Legislatures that sustained criticism of government spending makes it more difficult to improve U.S. infrastructure, from roads and bridges to aviation technology.
“I spend money to take my kids to a movie, but I invest in their education,” Foxx said, arguing that infrastructure builds the economy and offers greater access to opportunity.
Neither Cabinet officer explicitly mentioned party politics, but their remarks come as the Democratic administration and Republican congressional leadership ramp up their political rhetoric with multiple battles looming.
Sebelius oversees the 2014 launch of the health law’s two main provisions: anchor provisions to expand the Medicaid insurance program for low-income Americans and to set up insurance exchanges where the uninsured could buy private individual policies. Many Republican-run states have refused both.
Foxx, the former Charlotte mayor who was confirmed last month, is in the early stages of developing a new transportation program. Obama recently proposed $50 billion in new spending, financed by corporate income taxes. The current U.S. infrastructure spending program expires Oct. 1, 2014.
Both Cabinet officers tied the administration’s agenda in their policy areas to expanding economic opportunity for all Americans; the White House announced Monday that Obama will take a campaign-style bus tour through the northeast next week to talk about the economy and building the middle class.
Republican members of Congress are in their second week of constituent meetings during the summer recess, and many of them have doubled-down on their opposition to “Obamacare” and have assured their most vocal conservative constituents — some calling for a government shut-down to start the new budget year — that they will continue to battle the administration on budget debates. Meanwhile, some top GOP figures, including Obama’s vanquished election rival Mitt Romney, have been left to warn against such drastic moves.
In Atlanta, Sebelius reminded lawmakers that the health care law doesn’t hold states to their initial decisions on the anchor provisions. States have the final say on Medicaid. Sebelius’ agency, meanwhile, will run exchanges in states where governors and legislatures refuse.
“There is an offer on the table,” she said. “We are open to working with states.”
A former Kansas legislator, insurance commissioner and governor, Sebelius noted the fear among states that Congress will not hold to its original promises on Medicaid financing. The law proposes that federal taxpayers will cover expansion costs in fiscal 2014, 2015 and 2016, with the federal share eventually dropping to 90 percent, leaving 10 percent to each participating state. The expansion is intended to supplant existing federal and state payments to hospitals that treat the uninsured.
Sebelius assured lawmakers that “this is not a bait-and-switch,” and she noted that several states that plan to accept Medicaid expansion have required in law that they withdraw from the program if a future Congress ever reneges on the 90-10 cost split.
In his session with lawmakers and state transportation chiefs, Foxx emphasized Obama’s proposal for new infrastructure spending. He promised rural state lawmakers that the White House appreciates their needs for roads and small airports. He told officials from mostly urban states that Obama also appreciates the need for mass transit. And he said his agency is watching pilot programs and exploring ideas for using something other than traditional gasoline taxes to finance transportation projects.
Whatever the White House pushes, Foxx said, nothing happens without Congress: “Our constitution requires that there’s a dance involved here, and it’s hard to dance by yourself.”