Secretary Kathleen Sebelius, asked at a congressional hearing today why she hasn’t personally tried to enroll in the federal exchange, claimed that she wasn’t eligible because she has access to affordable insurance as part of her federal-employee compensation package. Colorado Republican congressman Cory Gardner countered that she could opt out of her federally provided employer coverage, which is correct. Any American, in fact, is eligible for the exchange, as Healthcare.gov helpfully explains:
Most people will be eligible for health coverage through the Health Insurance Marketplace.
To be eligible for health coverage through the Marketplace, you:
- must live in the United States
- must be a U.S. citizen or national (or be lawfully present)
- can’t be currently incarcerated
Americans who have access to “affordable” coverage through their employers (federal-employee plans easily count) cannot receive subsidies on the exchange, but Sebelius’s income would render her ineligible for subsidies anyway, regardless of her employer coverage.
Gardner’s questioning on the topic was met with a round of applause.
UPDATE: ThinkProgress claims that they have “confirmed” Sebelius is enrolled in Medicare, and notes that federal regulations prohibit brokers and agents from selling exchange plans to people enrolled in Medicare. It’s not clear, though, if it’d be illegal for Sebelius to buy an exchange plan, period (though that would be entirely pointless), since this looks more like an anti-fraud precaution to prevent brokers from taking avantage of seniors. That isn’t what Sebelius said, though — she says, “if I have affordable coverage available in my workplace, I am not eligible for the marketplace.” That’s false, and suggests Sebelius doesn’t understand a fundamental aspect of the law.
UPDATE II: The ThinkProgress writer, Igor Volsky, tweets that Sebelius is enrolled in Medicare Part A and holds a federally provided employer plan as well — which would take the place of Medicare Part B and D. Medicare Part A covers hospital expenses, while Medicare Part B is primary insurance and Part D is prescription-drug coverage; Sebelius is getting most of the coverage a normal insurance plan would provide with her plan from the Federal Employee Health Benefits Exchange (people delay enrollment in Medicare Part B for certain reasons). It’s not entirely clear if she could still purchase the insurance to cover that from the exchange, since the exchange plans aren’t intended to cover people over the age of 65.
In any case, that isn’t what America’s top health-care official said — she said she couldn’t buy an exchange plan because she has insurance from her employer. “That is part of the law,” she HHS-splained. It’s not.