MSNBC "The Rachel Maddow Show" - Transcript: Affordable Care Act


By:  Kathleen Sebelius
Date: Oct. 7, 2013
Location: Unknown


Joining us now for the interview is Kathleen Sebelius. She`s secretary of Health and Human Services, which, of course, is implementing the Affordable Care Act. Secretary Sebelius, thank you for being here.

KATHLEEN SEBELIUS, HHS SECRETARY: Nice to be with you, Rachel.

MADDOW: So, how -- in your own terms, from your own perspective. How would you assess the rollout of the exchanges?

SEBELIUS: Well, I think the exciting thing is that we are having a rollout of the Affordable Care Act. The final piece of implementation is here. What we are seeing is unprecedented interest across the country.

People calling on, the toll free hot line which is open 24/7. We have had over 600,000 calls. We have had over 10 million hits to the Web site. We have thousand of people setting up accounts and, shopping, simultaneously.

So, there is clearly a lot of pent up desire for the Web site. You are right. We have had some issues about volume, driving a difficulty of people getting in.

So, we are taking it seriously. The wait time is down today over where it was yesterday and the day before. We wanted to be as easy to use as possible, as seamless as possible. And we are confident that every day is getting a lot better.

But the interest is there. The product is there. We have companies for the first time ever in the history of the United States, competing for the business of individual policy holders. They can`t block them, because of the pre-existing condition.

They can`t medically underwrite their condition. They can`t put a lifetime limit on their benefits. They have to play by a new set of rules. That it is a brand new day for millions of Americans.

MADDOW: It seems the volume issues are both heartening obviously because it means that there`s pent up demand and people want this. It also seems to me like it should have been expected you. I mean, you guys did actually do a pretty good job of publicizing, what day one was going to be and what to do on day one.

And so that initial flood, I feel like if you want to try to get over people`s suspicions that government can`t administer anything right and that`s why they`re suspicious of health reform because it has something to do with the government administering these exchanges, having the exchanges be glitchy day one, not just growing pains, not just a problem of volume, but maybe a messaging problem for the law overall.

SEBELIUS: Would I have liked a much smoother rollout, you bet. I think the great news is we have 26 weeks of open enrollment. And this is -- in some ways like the kayak of health plans which has never been together before. But unlike kayak, we won`t sell out of the product. And the price doesn`t change.

So, day one, the prices are the same as the end of the rollout, in March 31st. We are eager to have people come take a look. Lots of folks need to learn about insurance. They`ve have never had insurance. They need to see what`s available for themselves and their families.

But, you know, six out of 10 eligible folks are going to find a plan for under $100 a month, very affordable coverage and, for the first time, have the kind of health security that many of us take for granted.

MADDOW: In terms of the way this is rolling out, and obviously, every state is different. There is three dozen states that have the federal government either running their exchanges or running some part of their exchanges, like 14 states. D.C. are doing their own.

SEBELIUS: Seventeen.

MADDOW: Seventeen. OK.

Is there -- are there additional challenges for you, in trying to make sure this -- this new law works for the country, to be having to simultaneously deal with states embracing it, and states that are rejecting it and fighting every step of the way? What are the challenges in the state like Texas for example?

SEBELIUS: Well, again, a lot of the states were running federal marketplace. Some of they less enthusiastic states at the governor`s level.


SEBELIUS: They haven`t embraced it. They`ve given a lot of misinformation. People get up every morning not sure the law applies to them, which is one of the reasons we have been so heartened by the flood of people the Web site, because somehow that information is getting through in spite of the best -- best, you know, efforts of the opposition to stop it.

I think what we have seen though is incredible support on the ground. Mayors in cities across this country are wildly enthusiastic, are mobilizing outreach enrollment effort. We have faith leaders. We have health care providers, disease groups, parents, health care advocates.

So, there is a mobilization on the ground. And that`s another point that, yes, people can go to the Web site, Again, it is getting faster. We are done to very low wait times. We are building capacity each of the nights so that more hardware, more engineers.

But there is also a toll-free call-in number open 24/7, answering questions in 150 languages. And you actually can enroll on the phone. Or there are people in neighborhood, in states around the country. Every federal health center has outreach and enrollment people. There are trained community volunteers who are able, one-on-one, to walk folks through an application. So, we anticipated that people would need help on the phone, on line, in person, and are building that into the process.

MADDOW: And to get coverage by January 1, the deadline is November, December 15th. By which you have to be signed up.

SEBELIUS: The coverage again, open enrolment last all the way to march 31st. The soonest the health plan starts is January 1st. That requires a December signup.

MADDOW: Kathleen Sebelius, our nation`s secretary of Health and Human Services. Good luck with this. It -- for the task that you have at hand, the faster this works the better off the country is going to be. Good luck.

SEBELIUS: I agree with you. Thanks.


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