HHS secretary, Grassley at odds over public option

Citing rising health insurance costs and the growing number of Americans without coverage, Health and Human Services Secretary Kathleen Sebelius said Friday there is an "urgent need" for congressional action on health care reform.

However, Sen. Chuck Grassley, the ranking Republican on the Senate Finance Committee that is marking up health care legislation, said Sebelius' prescription for a government-run health insurance option is neither practical nor the remedy Americans are seeking.

Citing data that health insurance premiums in Iowa have increased 88 percent since 2000 and 10 percent of Iowans are uninsured, Sebelius said it's time to make reform a reality.

"These are more than numbers and facts, more than statistics on a page," she said about data the federal agency released showing that health insurance premiums in Iowa have increased 88 percent since 2000 and 10 percent of Iowans are uninsured.

"What we know is that every day in America, families are being crushed by the high cost of health care that threatens their financial stability, leaves them exposed to higher premiums and deductibles and puts them at risk for the possible loss of health insurance as employers struggle to provide adequate health coverage," Sebelius said in a conference call with reporters.

Sebelius didn't have a prescription for a health care plan other than it must include a so-called public option, a government-run health insurance plan that would compete with private insurance.

"The president has made it pretty clear he actually believes in market strategies and feels very strongly having a public option compete with private insurers is the best way to have cost containment," she said.

Despite data she released showing that fewer Iowans have health coverage through their employer, Sebelius downplayed the risk that employers would drop coverage altogether if a public option was available. The public option, she said, would be available only to those now without health insurance coverage.

"There is concern about so-called dumping, but the president has made pretty clear he wants to encourage a system that builds on what we have," she said. "If you like what you have, keep it."

Grassley isn't as optimistic as Sebelius and her boss that employers will continue to offer health coverage. In fact, he suggested, that's the outcome some health care reform advocates want.

He cited a study by The Lewin Group, a health care and human services policy research and management consulting firm, that predicted 120 million people would leave their private insurance plans if a public option was offered.

"Then 50 million people who are left are going to see premiums go up and eventually they are going to opt out and you end up with single-payer system." Grassley said. "The public at large doesn't want government-run health insurance and the word public option doesn't say that, but that's where you end up."

He also downplayed Sebelius suggestion he and Finance Committee Chairman Max Baucus, D-Montana, have "recommitted" to getting a health care reform bill to the president.

"That would be correct if they left the "re" off," Grassley said. "Since Jan. 20 I've been working with Sen. Baucus and there's no recommitment because we've been committed since Day 1."

He remains optimistic Congress will send the president a health care bill this fall, but conceded there is a risk it could come undone.

"Oh, I've got people in the Senate who don't want to do anything talk about there's tremendous worry out here and it will be felt in the Congress," Grassley said. "The implication is anyone for this is in trouble. It could be, but my last town meetings didn't indicate that."

Iowa Health Care FYI

• Roughly 1.9 million Iowans get health insurance on the job where family premiums average $12,206, about the annual earning of a full-time minimum wage job.
• Since 2000 alone, average family premiums have increased by 88 percent in Iowa.
• 19 percent of middle-income Iowa families spend more than 10 percent of their income on health care.
• 8 percent of people in Iowa report not visiting a doctor due to high costs.
• Iowa businesses and families shoulder a hidden health tax of roughly $600 per year on premiums as a direct result of subsidizing the costs of the uninsured.
• 10 percent of people Iowans are uninsured, and 71 percent of them are in families with at least one full-time worker.
• The percent of Iowans with employer coverage has declined from 71 percent to 65 percent between 2000 and 2007.
• Small businesses make up 76 percent of Iowa businesses. Only 39 percent of them offered health coverage benefits in 2006 -- down 2 percent since 2000.

The full report is available at www.HealthReform.gov.