Health overhaul • Contrary to what the secretary said, the go-time isn't mandated.
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Washington • Misstating the health care law she is responsible for administering, Kathleen Sebelius has asserted that the law required health insurance sign-ups to start Oct. 1, whether the system was ready or not. In fact, the decision when to launch the sign-up website was hers.
The troubled debut of the government's health insurance enrollment website has raised questions about whether its start date should have been delayed to allow testing and repairs before it went live. Asked last week whether that might have been the wiser course, Sebelius, the health and human services secretary, said that wasn't possible because the law required an Oct. 1 launch.
In a visit to a community health center in Austin, Texas, on Friday, Sebelius acknowledged more testing would have been preferable. "In an ideal world there would have been a lot more testing, but we did not have the luxury of that and the law said the go-time was Oct. 1," she said.
But the law imposed no legal requirement to open the website Oct 1. The law says only that the enrollment period shall be "as determined by the secretary." The launch date was set not in the law, but in regulations her department had issued. Agencies routinely allow themselves flexibility on self-imposed deadlines.
Officials could have postponed open enrollment by a month, or they could have phased in access to the website. Oregon, one of the 14 states that built its own website under the federal law, did just that, allowing initial website access only for counselors instead of the general public.
Larry Levitt, health insurance expert at the Kaiser Family Foundation, said that in setting the sign-up start date the administration had to balance three competing interests: keeping the enrollment period short enough to prevent people from waiting to see whether they developed a health condition that needed insurance; keeping the period long enough to allow consumers to learn about their options; and allowing enough time to have the sign-up system ready for an onslaught of applications.
"Looking in the rear-view window, the systems obviously weren't ready by Oct. 1 and a delay would have allowed for a smoother launch," he said.
In the Texas appearance, Sebelius also pointed to a more likely reason behind the urgency to launch: politics, and in particular a government shutdown over the issue.
"A political atmosphere where the majority party, at least in the House, was determined to stop this anyway they possibly could ... was not an ideal atmosphere," she said.