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Obamacare Head Talks Open Enrollment, Ducks Problems

Health and Human Services Secretary Sylvia Burwell spoke at Miami Dade College.
Miama Dade College
Health and Human Services Secretary Sylvia Burwell spoke at Miami Dade College.

Health and Human Services Secretary Sylvia Burwell stopped at Miami Dade College last week to drum up excitement around open enrollment for health insurance plans—though during her stop she was not keen on addressing some of the problems that have come out of the Affordable Care Act.

She began her tour of MDC in a computer lab on the second floor of the downtown campus where there’s a bank of computers dedicated just to helping students enroll in Obamacare.

This story was originally published by WLRN and Health News Florida, a reporting collaboration supported by the Corporation for Public Broadcasting.

  Later at a press conference, Burwell said the Affordable Care Act has been about three things: “affordability, access and quality.”

She went on to detail indicators of progress under ACA: Medicare spending is $316 billion less than projected, young adults can stay on their parents’ health plans until they’re 26 years old, 17.6  million more Americans have health insurance.

“So progress on all fronts, but we want to make more,” she said.

Unintended Consequences

This is the third year of open enrollment under the Affordable Care Act and the people who remain uninsured are in many ways harder to reach than in years past.

One group of people who are not buying health insurance are those caught in the “family glitch.” These are people who cannot get tax breaks on Obamacare because one family member is offered family health insurance through an employer—regardless of how expensive those policy is or what percent of the family income it represents.

Sen. Al Franken, D-Minn., has introduced a bill that would close this loophole, but getting it passed is a challenge. Meanwhile, there’s been discussion from health policy watchers like the Urban Institute that HHS and the Treasury Department have the power to fix the family glitch through regulation.

When asked about a possible regulatory fix for the family glitch, Burwell said, “That’s an IRS issue,” and then quickly went back to talking points about affordability and quality.

A recent Kaiser Family Foundation study estimates there are more than 400,000 uninsured Floridians who can’t get tax breaks on a plan because they’ve been offered employer-sponsored insurance.

Burwell was similarly evasive when it came to the trouble with what’s called “balance billing”—also known as surprise billing.

Say a patient goes for a surgery at an in-network hospital and sees an in-network surgeon. That patient can still wake up to a surprisingly large bill if he or she didn’t know that an assisting physician, like the anesthesiologist, was out-of-network.

Burwell responded to a question about how HHS is addressing this balanced billing problem by pointing to a price estimate tool on and suggesting it’s up to patients to figure it out.

“We’ve added a feature that allows people to search and see what providers are in their network as part of what they’re doing,” she said.