Health and Human Services Secretary Kathleen Sebelius, visiting Miami on Tuesday for the second time in three months to promote the Affordable Care Act, vowed to finish the job of repairing the federally-run healthcare.gov website but also tried to refocus the discussion on Medicaid expansion — pushing back on weeks of withering criticism from opponents of the healthcare reform law.
Sebelius, who met with local counselors and South Florida residents at North Shore Medical Center, acknowledged that the Obama administration’s testing of the website in the months prior to the troubled launch “was not sufficient.”
“It should have been a longer period of time,’’ she said.
But she resisted answering any questions about whether she intended to step down, as Republicans leaders have called for, sticking to her message: “The important thing is to finish the job that we started.’’
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Sebelius’s visit was heavily orchestrated. Seeking to highlight still-rare healthcare.gov success stories, she met with a Miami Beach man, Nick Bianchi, 29, who was able to buy health insurance using the website that serves 36 states, including Florida. State-based online exchanges serve 14 states and the District of Columbia.
Bianchi, a self-employed social media consultant, said he had $600-a-month coverage through COBRA after leaving his job in the spring but his coverage lapsed when he forgot to pay his monthly premium in July. When he tried to buy the same plan on the individual market, the insurer declined him because of a pre-existing condition. He ended up with a short-term catastrophic plan for $280 a month until his new insurance begins: a mid-level “silver plan” that will cost him $311 a month. Though he didn’t qualify for federal financial help, he said he considers his experience buying insurance through the exchange a “success.”.
The message appeared designed to counter growing criticism of the president and his signature domestic policy due to technical problems that have kept many Americans from accessing healthcare.gov — and because health insurers have begun cancelling policies for many Americans whose plans do not meet the law’s requirements for coverage and affordability.
Sebelius said in September during a visit to Miami that the White House’s goal was to enroll about 7 million Americans over six months. But in the first month, only 106,000 Americans selected plans using the federal and state exchanges — about 27,000 by using healthcare.gov.
On Tuesday, Sebelius tried to refocus the discussion on Medicaid expansion, which Florida and other Republican-led states chose not to do: “The debate for Medicaid expansion is still very much underway,” she said.
Expanding the program would include those who earn up to 133 percent of the poverty level, or about $15,000 a year. By refusing to accept the federal government’s offer to pay 100 percent of the cost for the first three years and 90 percent thereafter, Florida is passing up about $51.3 billion over 10 years, Sebelius said.
“Here in Florida, there are 3.5 million uninsured and eligible Floridians who stand to benefit from full implementation of the law,’’ she said.
By not expanding Medicaid, Sebelius said, about 1.9 million Floridians will go without some form of health coverage, including “318,000 of whom are right here in the Miami area.’’
During Sebelius’ visit, several residents were in the process of enrolling. Sebastian and Yanette Castillon of Miami sat across a table from a navigator who spoke Spanish and helped them fill out and file their application to insure their four-member family. After filing their application through healthcare.gov, though, the website seized up: “Sorry, our system is down,’’ read the message, which advised them to try again in 30 minutes.
But the Castillons were not discouraged. Sebastian Castillon, 51, said the family has been using a discount card that he bought for $100 that entitles the family to see a primary care physician for a copayment of $20 per visit and specialists for $40 a visit for three-months. But he wants better coverage because his 19-year-old daughter sees the doctor every two months for a medical condition.
“I’d like to pay as little as possible because my resources are not many,’’ Sebastian Castillon said.
Karen Egozi, director of the Doral-based Epilepsy Foundation, said navigators enrolled two people for health insurance on Tuesday. She defined enrollment as selecting a plan and making the first month’s payment.
Egozi said that before Tuesday, Epilepsy Foundation navigators had successfully enrolled only nine people through healthcare.gov, but noted that “it’s getting better. They’re getting further into the system.’’
Carla Clauser, 32, of El Portal was waiting in line to meet with a navigator when Sebelius arrived. Clauser, whose family is uninsured, said she hoped to ensure all four people in her family but primarily her children, 3 and 7. About a month earlier, Clauser said she’d taken 3-year-old Sydney Miami Children’s Hospital emergency room for a high fever. She was told he needed Motrin — and then she was charged $1,500, subsequently discounted to $750 because she’s uninsured.
“It was a pretty big bill for them to tell us he needed some Motrin,’’ Clauser said. “I need some sort of coverage.’’