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Health and Human Services Secretary Kathleen Sebelius repeatedly told the House Energy and Commerce Committee on Wednesday that it would be “illegal” for her to sign up for coverage in Obamacare’s health care exchanges, raising eyebrows from health care journalists and pundits. The Washington Examiner’s Phil Klein wrote that “in reality, as stated on Healthcare.gov, she would be eligible to obtain coverage through an Obamacare exchange.” “She just wouldn’t be able to claim government subsidies to help her purchase insurance,” he claimed. CNN made a similar claim.
But ThinkProgress has confirmed that Sebelius, who turned 65 in May, is enrolled in Medicare and is thus ineligible to enroll for insurance through the exchanges. Exchange plans “duplicate many benefits provided by Medicare, and it is illegal for insurance companies, agents and brokers to sell such polices to people known to have Medicare,” federal officials told the New York Times in October.
In order to be eligible for coverage through the exchanges, individuals under the age of 64 “must live in the United States”; “must be a U.S. citizen or national (or be lawfully present)”; and “can’t be currently incarcerated.”
A CMS spokesperson clarifies that Sebelius is enrolled in Medicare Part A — Hospital Insurance — in addition to her employer sponsored coverage (FEHB).
Marilyn Moon, a Medicare expert, tells ThinkProgress that that the exchanges were never intended to serve people who are 65 and older and are normally covered by Medicare. “From that standpoint, no American is being asked to do that,” she said. Sebelius can un-enroll from Part A, but she may have a hard time convincing an insurer to accept her since “there is no risk pool for that” and don’t pay for the services covered under Medicare Part A. The rates in the exchanges are not designed for anyone who is over 65 years of age.