Top Oba­macare of­fi­cial says she wept for joy af­ter high court vic­tory

HHS chief says she’ll build on progress, push for Med­i­caid ex­pan­sion

The Washington Post Sunday - - POLITICS & THE NATION - BY LENA H. SUN lena.sun@wash­post.com

When Health and Hu­man Ser­vices Sec­re­tary Sylvia Mathews Bur­well saw on her of­fice com­puter that the Supreme Court was about to re­lease the muchan­tic­i­pated rul­ing on Oba­macare, she rushed out of her of­fice and down the hall to a con­fer­ence room where about two dozen se­nior staff were gath­ered. Be­fore she got there, she heard a cheer erupt from the room.

“And that’s the mo­ment that I knew,” said Bur­well, de­scrib­ing how she found out Thurs­day that the court had up­held a key part of the Af­ford­able Care Act, al­low­ing health in­sur­ance sub­si­dies to flow to all qual­i­fy­ing Amer­i­cans.

Bur­well also knew that the ini­tial media re­ports could be wrong, re­call­ing what hap­pened the last time the court ruled on a chal­lenge to the law. “Are we sure?” she asked her staff. She took a mo­ment to lean over a staff mem­ber’s shoul­der to read the de­ci­sion on a lap­top as staff mem­bers dou­ble-checked the opin­ion, ac­cord­ing to an of­fi­cial in the room. The mood in the room was joy­ful but also re­lieved. Some staff mem­bers cried.

Only then did the top Oba­macare of­fi­cial al­low her­self to be­come emo­tional and cry, she said.

In a meet­ing with re­porters Fri­day, Bur­well said the day of the rul­ing was “very emo­tional.” But now it’s time to fo­cus on what’s next, and she said she plans to spend her re­main­ing time in of­fice on­many of the other as­pects of the health law.

“I be­lieve it’s time to turn and build on the progress,” she said.

Re­peat­ing a theme she has stressed in re­cent weeks, Bur­well said she will work harder to help Amer­i­cans un­der­stand the law’s many other pro­vi­sions. Although the law — and the word “Oba­macare” — are un­pop­u­lar, many pro­vi­sions of the law are pop­u­lar. “Oba­macare isn’t con­nected to the ac­tual sub­stance” of the law, she said.

“It’s about your child of 26 be­ing able to stay on [par­ents’ health plan], it is about you no longer hav­ing to worry about pre­ex­ist­ing con­di­tions, it is about you can use pre­ven­tive ser­vices of­ten with­out a co-pay,” she said.

Bur­well said she also will make a re­newed push for states to ex­pand Med­i­caid, the state-fed­eral health pro­gram for the poor, and for chang­ing the way gov­ern­ment pays for health care by link­ing pay­ments more closely to the qual­ity of care rather than the quan­tity.

Asked whether health of­fi­cials had any new strat­egy to per­suade states to broaden Medic aid cov­er­age, Bur­well said: “I’m an op­ti­mist about the Med­ica id is­sue in terms of be­ing able to make some progress.”

She said she will con­tinue to reach out and work with gover­nors to come to un­der­stand­ings that suit each state’s cir­cum­stances, cit­ing re­cent agree­ments reached in In­di­ana and Florida. “We welcome the op­por­tu­nity to talk about how a par­tic­u­lar state needs to do this. . . . We think there’s a lot of space to get to agree­ment.”

The law orig­i­nally ex­panded Med­i­caid to in­clude all child­less low-in­come adults earn­ing up to 138 per­cent of the fed­eral poverty level (about $16,250 for an in­di­vid­ual). The Supreme Court ruled in 2012 that states could choose that op­tion. Twenty-one states have re­sisted, most of them led by Repub­li­can gover­nors.

T.J. KIRK­PATRICK/GETTY IM­AGES

The rul­ing was “very emo­tional,” Sylvi­aMathews Bur­well said.

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