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By Doug Bair
April 21, 2014
Caption : The outgoing cabinet member of the Obama administration who oversaw the rollout of the Affordable Care Act spent a few minutes with Generation Progress to discuss the 7.5 million Americans who enrolled in health care and that Between Two Ferns interview.     


After serving five years as Secretary of the U.S. Department of Health and Human Services (HHS), Kathleen Sebelius is officially leaving her post following the success of the Affordable Care Act‘s (ACA) initial open enrollment period.

But before she leaves her post later this month, the outgoing member of President Obama’s cabinet spent a few minutes with Generation Progress last week to discuss the millions of Americans who enrolled in health care—and that Between Two Ferns interview.

We know that 7.5 million Americans have signed up for insurance, surpassing the initial goal for the ACA’s first open enrollment period. As Secretary of Health and Human Services, the agency that oversaw the implementation of the law, are there any specific moments that stand out to you personally?

We’re now at 8 million!

Well before we implemented the final phase in October of 2013, we had lots of successes with the law. For example, we were able to get more than 3 million young adults on their parents’ policies. The law also made it illegal for insurance companies to discriminate against children with pre-existing conditions in October of 2010. Then the Supreme Court decision to uphold the law as constitutional (in June of 2012) was a huge day.

Certainly the IT failures in October and November stood out to me, along with everyone else in the country. But when the website was fixed, watching people begin to enroll in huge numbers was very gratifying.

After we were up and running, my most memorable moments were personal, where I heard stories from someone I ran into on the street or in the grocery line.

One of my favorites happened on a tiny plane, while I was traveling from one enrollment event to another. I was in a single-seat row, and the man seated in front of me was having an intense conversation with someone on his cell phone. Finally, the man turned around and explained that, while he knew it was odd and he was deeply sorry to disturb me, his wife was demanding that he give me his phone. So I somewhat reluctantly took it. On the other end of the line, an emotional wife told me that the Affordable Care Act saved her best friend’s life. You see, before the law, her friend couldn’t get insurance. Shortly after she bought a plan, she was diagnosed with cancer. Because they found it early, she was going to be OK.

It’s wonderful to hear stories like that. That is exactly why this law means so much.

With this initial open enrollment now closed, are there still chances when young Americans (such as those turning 26 who can no longer stay on their parents’ plan) can still enroll through the marketplaces?

Not only can those who age-out of coverage on their parents’ plans continue to sign up, there are several circumstances in which others may be able to sign up on the Marketplace throughout the year. Basically, if you lose your insurance because your life situation significantly changes, like getting divorced or changing jobs, these “qualifying life events” allow you to go to the Marketplace and shop for a new plan. Other events include graduating and losing a school’s health insurance, moving out of an area of coverage, certain changes in your income, or a new immigration status.

Additionally, members of federally recognized Native American tribes and people who qualify for Medicaid can sign up at any time.

You traveled to many states during this open enrollment period. What big things did you hear from young people about the ACA?

We tend to think that young adults don’t get covered because they don’t believe that they’ll ever get hurt, but many of the ones I met wanted health insurance. They just didn’t think they could afford it.

Thankfully, most of those same young people found great prices on the Marketplace. And they told me the same thing I heard from people of all ages, that affordable coverage was a relief. No one wants to have to worry about how they will pay for a sports injury or avoid a needed checkup because they can’t afford it.

A lot of young Americans loved President Obama’s interview with Zach Galifianakis on Between Two Ferns. Can you talk about these unique efforts to reach out to young Americans?

Young Americans have the highest rate of uninsurance and are the least likely to have employer-based insurance, so Affordable Care Act provisions like lowered premiums and preventive care at no extra cost are even more beneficial to them. So it was very important to reach that group and we wanted to use every tool we had.

Most young Americans use social media and pay attention to actors and athletes. We had lots of celebrities who were eager to help in any way because they believe in the President and in the importance of expanding health care. Using humor or sports stars or Hollywood talent to get the attention of young Americans just makes good sense.

And it worked: traffic to the site shot up 40 percent after “Two Ferns” was released, reaching nearly 900,000 visits the day it was released.

As you reflect on your years in public service as both a governor and cabinet member, do you have any advice for young Americans who aspire to serve their country in similar capacities?

Public service isn’t an easy career path to take, and it’s one that can be full of sacrifice and challenges. But the reward is that sometimes you really do get to change the world.

As with any field, the formula for success is lots of hard work and some luck along the way. More than anything, though, you have to be an optimist. It’s easy to become a cynic, but it’s harder—and far braver—to believe that progress is possible. Having the courage to try and make America better is the only way we’ll ever get there.

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