Posts tagged with Sebelius
Officials in Gov. Sam Brownback’s administration fired back Thursday at former Gov. Kathleen Sebelius over comments she made about Medicaid expansion, accusing Sebelius of having created the so-called “waiting lists” for elderly and disabled services in the first place. This all started a few days ago when Melika Willoughby, a young deputy communications director in Brownback’s office, sent out an email to political supporters, asserting that expanding Medicaid, as allowed under the Affordable Care Act, aaka “Obamacare,” would be “morally reprehensible” because it would prioritize able-bodied, childless adults over the frail elderly and disabled who are already on waiting lists to receive services. That led to Sebelius’ comment to the Journal-World Wednesday. Sebelius, one of the architects of Obamacare and the person largely responsible for implementing it during its first couple of years, called that statement “flat-out wrong” and said the only reason there are waiting lists is because the Brownback administration has underfunded the program. That, then, prompted Kansas Department for Aging and Disability Services spokeswoman Angela de Rocha to fire back late Thursday, calling Sebelius’ comments “wildly inaccurate.” “The Governor and the Legislature have made significant investments in increased funding to provide services to people with disabilities by investing in bringing people off waiting lists and into services, more than $65 million to date,” she said. In addition, she accused the Sebelius administration of creating the waiting lists in the first place when, in 2008 and 2009, in response to collapsing state revenues amid the global financial crisis, it implemented rule changes that reduced the number of people who received what are called “Home and Community Based Services.” This escalating war of words between the Republican and Democratic camps gives some indication of how heated this issue is likely to be in the next session, not to mention the 2016 elections. And so it merits some background and explanation.
First, what are the “waiting lists” for elderly and disabled services? Under Medicaid, low-income elderly and disabled individuals who can no longer take care of themselves are entitled to receive care in nursing homes. The problem is, that’s very expensive and, in many cases, unnecessary if the individual could only need a little help around the house. So in the 1990s, the states and the federal government started devising “waiver” programs to provide what are called “Home and Community Based Services,” or HCBS. It’s a waiver from the general rule that says the care has to be provided in a nursing home. Under the waiver, Medicaid will pay for medical care as well as certain nonmedical services such as house cleaning, home health aides, personal care, adult day health services, etc., so the individual can continue living at home. Kansas currently has six different types of HCBS waiver programs. They apply to the frail elderly; developmentally disabled; physically disabled; autism patients; traumatic brain injury patients; and those who need technology assistance. HCBS programs are cheaper for everyone because the government isn’t paying the cost of the physical plant of a nursing home. The individual lives in his or her own home. They’re also considered to be better, more humane forms of care because they leave individuals with a degree of independence and self-determination. The problem is, they’re not an entitlement the way nursing home care is. States have to budget for HCBS programs, and the federal government will kick in whatever its matching share is. (In Kansas, it’s about 55 percent of the total cost). But the number of people who get served is essentially capped by how much the state agrees to kick in. Since the inception of the program during Republican Gov. Bill Graves’ administration, the demand for HCBS programs has almost always outstripped the available funding. And, so, people are put on waiting lists.
How would expanding Medicaid affect the elderly and disabled who are on waiting lists? Sebelius’ argument is that it wouldn’t. They’re completely different programs. The frail elderly and disabled individuals who may qualify for HCBS plans are still entitled to medical care through nursing homes. And the state would still be in control over how much it spends for home and community-based care. The expansion of Medicaid to cover all individuals in households up to 138 percent of the poverty level is entirely separate. And, for the first three years, it would be 100 percent funded by the federal government. That gradually scales down to 90 percent in a few years, but Sebelius still calls it the most generous federal-state cost sharing program in U.S. history. Brownback, however, counters that as a practical matter, one does affect the other because the state has limited resources. Eventually, the state will have to pick up some share of the Medicaid expansion cost. And he says it’s unfair to add that cost onto the Medicaid system for able-bodied, working-age adults when the state is struggling to serve all of the elderly and disabled people who want HCBS plans. Sebelius’ counterargument to that is, it doesn’t have to be an either-or proposition. States can and — in her view, at least — should do both.
Health and Human Services Secretary Kathleen Sebelius, who was sharply criticized for problems with the rollout of Healthcare.gov, got big laughs Saturday night at the White House Correspondents Association dinner, when she came on stage as part of a joke to fix a technical glitch during President Barack Obama's speech.
Obama introduced a video, but when it failed to load properly. Obama asked, "Does anybody know how to fix this?"
Sebelius, the former governor of Kansas, stepped out and said, "I got this. I see it all the time."
Sebelius announced last month that she will be stepping down from her post.
In his criticism of U.S. Sen. Pat Roberts, R-Kan., on Monday, Dr. Milton Wolf indicated Republicans shouldn't make friends with Democrats and that New Jersey Gov. Chris Christie's recent controversies have been caused by the media.
Wolf, a tea party-backed challenger to Roberts in the GOP primary, was interrupted several times by applause during his 24-minute talk to about 50 people who attended an event put on by the Douglas County Republican Party at Famous Dave's restaurant.
One of Wolf's major criticisms of Roberts is that Roberts voted in the Senate to confirm President Barack Obama's selection of Kathleen Sebelius in 2009 as secretary of Health and Human Services. Sebelius has been at the forefront of implementing the Affordable Care Act, commonly called Obamacare, which is opposed by all Republicans in Congress.
"One of the problems with our party is too often we're the go-along to get-along party," said Wolf. "We try to get people in the media to like us, we try to get the Democrats to like us. It never works. Ask Chris Christie about that. He can walk on the beach every day of the week with Barack Obama, but as soon as he starts looking like a candidate for the presidency, the media is going to stab him in the back," Wolf said.
In 2012, Christie, a Republican, praised the response of President Obama and the federal government to Hurricane Sandy, which battered the Northeast. Christie's appearances with Obama just days before the presidential election was criticized by some Republicans as helping Obama.
Recently, Christie has been embroiled in controversy over an allegation that his aides closed lanes to the George Washington Bridge in political retribution against a New Jersey mayor.
Wolf added, "You cannot make friends with our adversaries, and yet what we have — and this should trouble us all to know — is we have Sen. Roberts who voted to put Kathleen Sebelius in charge of Obamacare," he said.
Sebelius was confirmed as secretary on a 65-31 vote. Nine Republicans voted for her, including Roberts and then-U.S. Sen. Sam Brownback, a Republican who is now governor of Kansas. In recent months, Roberts has called for Sebelius to resign after the troubled roll-out of the ACA's enrollment website.
The campaign of Dr. Milton Wolf, the Tea Party activist challenging U.S. Sen. Pat Roberts, R-Kan., says Roberts' call for the resignation of U.S. Health and Human Services Secretary Kathleen Sebelius was "too little, too late."
Wolf's campaign said Roberts should apologize for voting to confirm Sebelius as President Barack Obama's secretary of Health and Human Services. Sebelius, a former Kansas governor, is implementing the Affordable Care Act.
"With her help, President Obama and the democrats rammed through the most disastrous legislation in recent history. Senator Roberts owes every American an apology," Wolf's campaign said.
Wolf, a radiologist from Leawood, announced his candidacy in the 2014 Republican Party primary last week. Just days later, Roberts issued a news release, saying that Sebelius, a former Kansas governor, should resign for "gross incompetence" because of glitches in the rollout of the federal online health insurance marketplace under the ACA.
The HealthCare.gov federal website for the health insurance marketplaces has been plagued with technical problems that have prevented many from enrolling.
Sebelius has acknowledged problems and said technicians were trying to expand the site's capacity. The website became operational Oct. 1.
Meanwhile, the Roberts campaign issued a statement saying that it ended the quarter Sept. 30 with $1.8 million cash on hand for the campaign, and touted Roberts' ranking as the fifth most conservative senator, according to Heritage Action.
"Kansans know that Pat is the tough, tested and trusted conservative in this race," said Dave Murfin, of Wichita, and Statewide Co-chair of Roberts for Senate.
Topeka — Republicans refuse to vote for an almost routine provision to fund government unless a Democratic chief executive approves their demands.
That's what happened in Kansas in 2009 between then-House Speaker Mike O'Neal, R-Hutchinson, and then-Gov. Kathleen Sebelius, a Democrat.
Led by O'Neal, Republican legislative leaders, including then-Senate President Steve Morris, R-Hugoton, refused to agree to issue inter-governmental loans to make state payments for payroll, public schools, health and income tax refunds.
The Republicans said they would sign off on $225 million in what are called certificates of indebtedness, if Sebelius would sign into law deep budget cuts.
Republicans said they couldn't approve the certificates because without approval of the budget rescission bill, the state ledger would be out of balance. Sebelius said that was nonsense because the state's budget problems and cash-flow situation were unrelated.
Democrats said the move by Republicans amounted to blackmail and made thousands of state employees worry about getting paid.
But Sebelius ended up signing the rescission bill, although she applied several line item vetoes, including a veto of a $32 million cut in state aid to public schools.
About the same time this drama was occurring in the Statehouse, reports were coming out of Washington, D.C., that Sebelius was President Obama's choice for Health and Human Services secretary. She was confirmed secretary about two months later.