The fight for acceptance of Obamacare can be compared to Medicare: one day it will be fully embraced, says former Health and Human Services Secretary Kathleen Sebelius.
In an interview with Politico, Sebelius, who resigned in April after the
botched rollout of the program, said Obamacare was worth fighting for and should serve as an inspiration to lawmakers for future battles over social programs.
"I say go for it," Sebelius
told Politico. "I think change is very, very hard, and there is always a default position of, either do nothing or do something very small and get in and out of the battle as quickly as possible."
"I think it was not only well worth it, but a battle worth fighting," Sebelius said. "Millions and millions of people are the beneficiaries of this policy."
Sebelius pointed to long-term care as one of the challenges on the horizon, given that it was not part of the healthcare law.
She also reflected on the rocky rollout, saying she wished it had gone more smoothly. She insisted, however, that she and other top administration officials never had clear warnings from contractors that the website wasn't ready, which might have enabled them to postpone the program's launch, Politico reported.
"I certainly would have much preferred a very smooth rollout and robust enrollment from day one, but I also feel very good about the fact that this president was able to get a law passed that 70 years of debate prior to him, of both Republican and Democratic presidents, had failed to do," she said.
Sebelius said there were elements of the implementation that did go well.
"There were pieces of this puzzle being put in place along the way that were not insignificant in either money or impact, and actually got up and running in very short order," she told Politico.
Some Democrats have expressed regret that Obamacare moved forward without Republican votes, among other concerns about the law and its implementation. But Sebelius said the administration went to great lengths to include Republicans and it was important to move forward regardless.
"You hear echoes of that debate in immigration. Would people like a bipartisan, comprehensive approach to immigration? You bet," Sebelius said. But "the only way to move forward is really executive authority right now, because there isn't a bipartisan approach."
Nevertheless, Sebelius acknowledged there were lessons to be learned. For one, she says there needs to be an overhaul of the contracting rules for information technology projects such as HealthCare.gov.
"People kept saying, well, why don't you have, you know, the best new startups? . . . Well, that's not how you get into government contracting," Sebelius told Politico.
The contracting rules "required kind of pre-qualifications, it required some substantial history with contracting; I mean, a whole set of rules and protections that are in place, I think, to make sure you get the best and most solid proposals, but I'm not sure they work particularly well in the technology area."
She also said there needs to be better coordination between the technical experts and the policy professionals.
"Clearly, there were lots of lessons about making sure that the policy side, the [regulations] being written, what people wanted to have happen as you used technology, was really intimately integrated with what they were building, and I don't know that that happened to the extent that it should have or could have," she said, according to Politico.
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