Weâre working on it.
No matter what the topic â from improving consumersâ experience with , the health lawâs Medicaid expansion, narrow networks and even Ebola â Department of Health and Human Services Secretary Sylvia Mathews Burwell told reporters Thursday her agency is on it.
During a breakfast with reporters sponsored by Kaiser Health News and the health policy journal Health Affairs, Burwell tried to manage expectations about the health lawâs next open enrollment season and declined to make a prediction about how many people would enroll this time around. She also cautioned that we are likely to see the number of Ebola cases rise before the crisis subsides.
A year ago Thursday, then Office of Management and Budget chief Burwell was in the caused by a battle with Republicans over for the very health care law sheâs now charged with implementing. Her success â or failure â over the next year in fixing problems with healthcare.gov and shaping public perception of the law may define its role in the 2016 presidential elections and well beyond.
The themes Burwell expressed during her question-and-answer session with reporters were familiar to those who have followed the secretary, who just passed her . Expect improvement â but not perfection â when enrollment on healthcare.gov begins again Nov. 15. HHS officials are working with insurers, consumer groups, state officials and others to find out whatâs right and whatâs wrong with the website to make the user experience faster and simpler.
Ongoing testing of the site should mean it can handle increased traffic far better than the debacle of a year ago where numerous outages infuriated millions and gave the GOP even more fodder in their campaign to defund or repeal the entire law. Â Work continues on the âback endâ of the site, which deals with communications between the government and insurers.
Burwell took questions on a wide range of topics and her answers were careful and measured:
â When asked if she was taking a âback seatâ on the administrationâs response to the Ebola crisis, Burwell made it clear sheâs on top of it â sheâs often conducting three meetings a day on the issue. But sheâs comfortable to let colleagues who are experts, , chief of the Centers for Disease Control and Prevention,  director of the National Institute of Healthâs infectious disease institute, get more time at the microphone during press briefings. Burwell didnât mince words when it came to estimating the number of cases ahead.  âThe numbers are going to increase before we get to a leveling off point,â she said. On Wednesday, the first person diagnosed with the disease in the U.S. and in West African countries.
â Burwell acknowledged that the data on the Centers for Medicare & Medicaid Servicesâ âwasnât perfectâ but said HHS went forward with its release in an effort to improve government transparency.
â In response to a question about a recent that found some insurers were not properly ensuring that federal subsidies to help pay for health coverage were not being used to fund abortion, Burwell said that no federal funds were being spent on abortion except in cases of rape, incest or to protect the life of the mother, consistent with current law. She also said HHS is working with states and insurers to make sure they understand what the law requires. She added that the GAO report was based on last yearâs plans â not those offered for 2015.
â HHS is working with governors who have yet to expand their Medicaid programs â a provision of the health care law the Supreme Court made optional for states â and to clear backlogs in other states where people who have signed up for Medicaid coverage have yet to receive it. She mentioned Indiana, Tennessee and Utah as states that she is in active discussions with about expansion. âWe have to think about what flexibility they need and what is the best approach for their state,â she said.
â Burwell declined to give a target health law enrollment figure for 2015, pointing instead to a that exchange enrollment is projected to hit 13 million next year and climb to 25 million by 2017. âNow we actually have information about what happened in the first open enrollment periodâŠ.We want to try and to build that number, bottom up, based on what we know [about] those who did enroll,â she said.