WASHINGTON — Kathleen Sebelius, the U.S. Secretary for Health and Human Services (HHS), stepped down from her post, amid ongoing criticism of the disastrous rollout of the Affordable Care Act (ACA) and an explosion of legal challenges to the contraception mandate, authorized under the ACA and approved by her.
The White House announced on April 10 that Secretary Sebelius had offered her resignation. President Barack Obama nominated Sylvia Mathews Burwell, the director of the White House Office of Management and Budget, as a replacement on April 11.
Sebelius’ resignation is widely viewed as an attempt to defuse public anger over the health law, widely known as Obamacare, in advance of the midterm elections.
But critics of her tenure, especially her involvement with the ACA’s provisions for contraception and elective abortion, emphasized that President Obama was ultimately accountable.
"As the head of Health and Human Services, she reflected the president’s agenda and her own to use the expansion of health care to the poor — a goal the Church has always supported — to expand abortion and promote the use of abortifacients and to coerce the Catholic Church and others to violate our conscience," Archbishop Joseph Naumann of Kansas City, Kan., told the Register.
Doug Johnson, the National Right to Life Committee’s legislative director, echoed Archbishop Naumann’s judgment.
"Sebelius has been the administration’s point person for expanding federal subsidies for abortion" under the ACA, said Johnson.
"But the paramount responsibility rests with those who enacted these laws and policies — the administration and the Congress."
However, the Catholic Health Association (CHA), an industry lobby, expressed support for her leadership and disputed pro-life concerns about the ACA.
"The secretary has been a working partner with CHA and always willing to listen to our concerns and ideas for improving upon the ACA. We wish Secretary Sebelius the best in her future pursuits and look forward to working closely with her successor to make sure the ACA continues to be implemented fairly and effectively and to protect lives from conception until natural death," said Daughter of Charity Sister Carol Keehan, CHA’s president, in an email message to the Register.
"We continue to be confident, as we have been since the law passed, that ACA does not enable federal funds to be accessed for abortions (except for Hyde provisions)."
Sebelius, a self-identified Catholic, has been at the center of the Obama administration’s controversial efforts to reframe access to contraception and abortion as a matter of "women’s health," with the goal of making them an essential part of mainstream medical care. In 2010, the Affordable Care Act was passed by Congress without a single Republican vote, after the White House reassured pro-life Democrats that the law would not provide federal subsidies for abortion.
Church leaders were skeptical that the promise would be fulfilled, and they withheld support for the health-care law. And in 2011, Cardinal Timothy Dolan of New York, then the president of the U.S. Conference of Catholic Bishops (USCCB), raised the alarm about a slew of White House policies that threatened the free exercise of Catholic institutions, including an HHS policy change that ended federal grants to the USCCB’s top-rated program for trafficking victims because Church services excluded contraceptives.
Free Exercise at Stake
During an October 2011 speech at a NARAL fundraiser, Secretary Sebelius fought back against the administration’s pro-life critics, telling her fellow guests: "We are at war." And, by January 2012, she had approved the contraception mandate, which requires most private employers to provide co-pay-free abortifacients, sterilizations and contraceptives in their employee health plans.
"I believe this proposal strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services," she stated in a press release, though Catholic criticism of the law’s narrow religious exemption would prompt President Obama to approve a series of "accommodations" that would be rejected by the bishops’ conference as inadequate.
By February, with the 2012 presidential election in sight, Democrats had reframed free-exercise concerns about the mandate as a "war on women."
It would take almost two years for the debate over the mandate to shift from the political sphere to the courts. On March 25, the U.S. Supreme Court heard oral arguments in a pair of legal challenges to the law filed by two for-profit employers, and many legal experts predict that the justices will likely provide a narrow ruling in favor of the plaintiffs.
The Eternal Word Television Network (EWTN) is among the large group of nonprofit plaintiffs suing Sebelius, in her capacity as HHS secretary, in court. The Register is a service of EWTN.
Rocky ACA Rollout
Meanwhile, the HHS secretary struggled to effectively manage the rollout of HealthCare.gov, the federal insurance exchange website, where consumers were directed to shop for plans, with some Americans receiving federal subsidies on a sliding scale.
Technical problems on the website forced the administration to repeatedly extend the deadline for enrollment, and the White House has issued additional regulations designed to delay the impact of the law on individuals, employers and people who had lost their health insurance because their old plans did not cover all the provisions required under Obamacare.
"In the broader context of the health-care law and its rollout, she was the head of the agency that really fumbled the initial effort," James Capretta, an expert on domestic social policy at the Washington-based Ethics and Public Policy Center, who has been sharply critical of the law’s provisions, told the Register.
"The jury is out on the entire program, and the administration feels it has turned a corner," Capretta added, noting that some consumers with pre-existing conditions have benefited from the ACA’s provisions, but doubts remain about the long-term affordability and broad impact of a law that is consolidating federal control over the health-care sector.
Administration officials have insisted that Sebelius, 65, was not forced out, and President Obama has hailed her efforts to increase the number of enrollees on health-insurance exchanges authorized under law to 7.5 million people — though critics have disputed that figure.
U.S. Rep. Nancy Pelosi, the House Democratic leader from California, led the effort among party leaders to put a positive frame on Sebelius’ legacy. Pelosi commended the HHS secretary as "a leader in the long effort to make history for our country with passage of the Affordable Care Act."
"Her legacy will be found in the 7.5 million Americans signed up on the marketplaces so far, the 3.1 million people covered on their parents’ plans and the millions more gaining coverage through the expansion of Medicaid," said Pelosi.
Clash With Church
In her statement, Pelosi noted that she and Sebelius had both attended Trinity University, a Catholic college in Washington, and she suggested that their record of public service reflected the school’s "values."
Over the years, Pelosi has frequently introduced her cradle-Catholic faith into her policy positions — either by noting her disputes with the teaching authority of the Church or critiquing Republican spending cuts as anti-Christian, while Sebelius has been less forthcoming.
Still, during her tenure as HHS secretary, Sebelius became a polarizing figure among Catholics. When the U.S. bishops learned she had been invited to speak at a 2012 graduation event at Georgetown University, the Archdiocese of Washington issued a statement that sharply rebuked Georgetown for selecting "a featured speaker whose actions as a public official present the most direct challenge to religious liberty in recent history."
Amid the barrage of criticism of Sebelius’ management failures, Pelosi and other party leaders also emphasized her strong record as the governor of Kansas. But pro-life leaders in Washington and Kansas dispute that judgment, noting her well-documented support for abortion, including her backing of the late George Tiller, the notorious abortionist who performed late-term procedures.
Back to Kansas
While Sebelius served as the governor of Kansas, Archbishop Naumann directly confronted her unapologetic support for abortion and ultimately ordered her not to receive the Eucharist.
During an April 11 interview with the Register, the Kansas City archbishop said he was "saddened" by the news of her departure, given that it signaled her failure to effectively manage a key initiative designed to help uninsured Americans obtain access to health insurance, possibly for the first time.
"I was saddened, in one sense, that Sebelius’ exit from Health and Human Services is because of the failure of the implementation of Obamacare," said Archbishop Naumann.
"What is a greater sadness to me is what she did as the HHS secretary was completely consistent with what she did in Kansas on moral issues important to the Church.
"Here, she was an opponent of every legislation that would protect children or women involving regulation of abortion clinics. She was an advocate of the abortion industry."
Sebelius is expected to return to Kansas, where her husband serves as a magistrate judge. And Archbishop Naumann said he would "pray that, now that she is out of public life, she might reflect on these things" and reconsider her views.
With Sebelius’ departure, the White House is touting Obamacare’s newly robust enrollment figures and working to turn a scandal-plagued rollout into a plus for Democrats who backed the health law and are facing a tough campaign season.
ACA’s Subsidies for Abortion
Meanwhile, the bishops and pro-life activists have called for a careful reading of several key problems with the health-care law that still need fixing, including the lack of specific language barring federal subsidies for elective abortion.
"The ACA bypasses the appropriations process, thus bypassing the Hyde Amendment and similar riders, and for many programs, it supplies nothing in their place," explained Richard Doerflinger, the associate director of the bishops’ Secretariat of Pro-Life Activities, in an April 7 column in America, the Jesuit publication.
The National Right to Life Committee’s Johnson confirmed that "24 states have passed laws keeping abortion off their state exchanges. But in the 26 states that have not passed these protective laws, the federal subsidies will flow to millions of enrollees to purchase plans that cover abortion," and he warned that it was difficult for consumers to discover which plans cover abortion.
Said Johnson, "Sebelius has presided over the opening of the floodgates to a massive flow of federal subsidies to purchase plans with elective abortion. It is happening now."