When Health and Human Services Secretary Sylvia Mathews Burwell saw on her office computer that the Supreme Court was about to release the much-anticipated 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 on many 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 pre-existing 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 Medicaid coverage, Burwell said: “I’m an optimist about the Medicaid 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.