How Kathleen Sebelius Should Have Handled Her Daily Show Interview


Jon Stewart grilled Health and Human Services Secretary Kathleen Sebelius about the implementation of Obamacare on The Daily Show Monday night, demanding to know why the administration granted businesses with more than 50 employees a one year reprieve from the employer responsibility provisions in Obamacare, but is still penalizing individuals for not purchasing health care coverage this year.

Here, Sebelius flailed: she first argued that most large businesses are already complying with the coverage requirement, then said that small businesses are exempt from any mandates and finally settled on, “nothing that helps an individual get coverage has been delayed at all.”

The triangulation didn’t satisfy Stewart and for good reason. Sebelius failed to state the obvious: the government delayed the business mandate — a provision that applies to just 4 percent of businesses — because it is extraneous to reform; the individual mandate is central to it. And, maintaining the delicate balance of the law’s health care marketplaces and keeping premiums affordable is more important than the perceived unfairness of starting two separate provisions a year apart.

The fact is, the administration passed Obamacare to correct an unfairness in the health system that allowed insurance companies to cherry pick who got coverage, how much they paid for coverage, and when that coverage could be terminated. Before Obamacare became the law of the land, people lost their insurance if they lost their jobs and often found themselves one illness away from bankruptcy. The nation’s health care system was unfair to them and to the insured population, which paid higher premiums as a result.

The new Obamacare marketplaces aim to level the playing field by extending insurance coverage to everyone. But those markets can’t function unless everyone takes responsibility for their own health care costs and buys insurance now, not a year from now. Young, uninsured and healthy Americans have to start paying into the system as soon as possible, financing the care of today’s sick so that they too will have their future health care bills paid for.

That’s the basic tenet of insurance and if the administration agreed to delay that component, it would treat millions of Americans unfairly. As a result, young and healthy people would be less likely to purchase insurance, increasing premiums for everyone who enrolls in coverage in the health care exchanges and pricing 11 million people out of the market in 2014. This is the price for the false equivalence Stewart is proposing.