Sebelius Nears the Third Rail of Politics

Kathleen Sebelius has a tough job ahead of her: As secretary of Health and Human Services, she not only has to implement the sweeping health care reforms just enacted, she also has to help sell Americans on the benefits of the bill.

Today, she made a sales call to the National Press Club, where she delivered a luncheon address titled “Health Reform and You: How the New Law Will Increase Your Health Security.” It was not a memorable speech—the former Kansas governor delivered the speech in a flat, Midwestern monotone. There were no flights of oratory, no emotional anecdotes that pulled on your heart strings. It was just a list of facts—real improvements that will be made, starting this year, to our nation’s health care system.

The most memorable moment came during the question-and-answer portion of the address. Sebelius was asked about whether the age for Medicare eligibility should be raised to 70. She first noted that President Obama has appointed a commission to look at the nation’s long-term debt crisis, which largely is due to entitlements like Medicare, Social Security, and Medicaid. But instead of giving a safe answer like, “We’re looking forward to the commission’s recommendations,” Sebelius came awfully close to touching the third rail of politics. She said the rules for programs like Medicare and Social Security, including eligibility ages and the benefits provided, “will be a topic that will be robustly debated and discussed.”

“I think it it is very appropriate,” she said. Everything should be looked at, she added.

That’s the right answer from a policy perspective, but it could cause political problems for her boss. A headline writer might paraphrase her response as follows: “Obama open to raising retirement age; Medicare benefits could be cut.”

That’s not the sort of debate the president needs to be engaged in now, not after the bruising battle to get health care reform passed. The safer road for Sebelius is the one she intended to follow: Outlining the benefits of health care reform.

“The more Americans learn about this legislation, the more they’ll like it,” she said.

Her department “will serve as a nationwide health insurance reform help desk,” she said. It’s already launched Healthreform.gov, which features fact sheets such as how small businesses can take advantage of tax credits, starting this year, to help them provide coverage to their employees.

While many of the reforms—such as health insurance exchanges for individuals and small businesses—won’t be implemented until 2014, other pieces of the health care overhaul will go into effect as early as this year, including new high-risk pools to cover people with preexisting conditions until the exchanges are up and running. Sebelius already has asked states about their plans to participate in this program.

Starting June 15, seniors who hit the “doughnut hole” on prescription drug coverage will be eligible for a $250 rebate to help them pay for their medicines. Rules ending lifetime caps on benefits and preventing insurers from canceling your coverage when you get sick also go into effect this year.

As these reforms phase in, many Americans will likely decide health care reform is OK after all. Calls of Republicans to “repeal and replace” the bill may fall on deaf ears, except for the Tea Party crowd. That’s why Sebelius and other Obama administration officials are spending so much energy promoting the bill after it’s already been enacted.

But that effort will be undercut if Sebelius doesn’t keep her mouth shut about raising the Medicare eligibility age or changing Medicare benefits. Those steps will be necessary, of course. Everyone knows Medicare is on an unsustainable course financially. But that’s an issue for another day, maybe even another president.

As Madame de Pompadour, mistress to Louis XV, said, “After us the deluge.”

The rains came, of course, but it was Louis XVI that paid the price.

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