Political Hot Seat

Through eight stressful weeks last year, Kathleen Sebelius, the former secretary of the U.S. Department of Health and Human Services, had to assure Congress that yes, the HealthCare.gov website would indeed be working by Dec. 1, all the while not being totally certain that would happen. “We did fix it,” she said, “but it was not a pleasant eight weeks.”

During a question-and-answer session Oct. 28 on Tufts’ Medford/Somerville campus, Sebelius offered a behind-the-scenes look at the Affordable Care Act. She also commented on the Ebola epidemic and explained that she initially got into politics for an unusual reason—to have a part-time job.

Sebelius was the second participant in the Tisch College Distinguished Speaker Series, which last month featured Massachusetts Sen. Elizabeth Warren. Alan Solomont, A70, A08P, the Pierre and Pamela Omidyar Dean of Tisch College, moderated the discussion.

Sebelius’ political career began in 1987, when she was elected to the Kansas House of Representatives. She later became the state’s insurance commissioner. She was governor of Kansas from 2003 to 2009, when she joined President Obama’s cabinet, serving as secretary of health and human services until earlier this year.

She oversaw the implementation of the Affordable Care Act, more commonly known as Obamacare. When the website HeathCare.gov crashed upon launch, it drew a firestorm of criticism, and Sebelius was in the thick of it. Many people called for her to fire the website developers. But, she told the Tufts audience, she couldn’t—they were the only ones who knew the code.

“It was terrifying,” she said. “The notion that we might have to tell the president we’d have to scrap the whole thing was not good. We had people looking at it from all angles who said we think in eight weeks this can work.” The best she could do while the site was being fixed, she said, was to own up to the mistake, apologize for it and then get on with fixing the problem.

Sebelius also talked about the genesis of the Affordable Care Act, one of the ideas that attracted her to Barack Obama’s candidacy for president. After the economic downturn, many of Obama’s advisers suggested he abandon the idea or, at best, do something much smaller.

“Every step of the way, it was really the president who kept saying, Is there a way to go big? Is there a way to do a comprehensive bill?” she said. When the House and Senate finally passed separate bills, she said, it was the president who spent two weeks negotiating the compromise bill between the two houses of Congress. “He was at the table every minute of the day,” she noted. “Senators would storm off, and he would bring them back. Representatives would storm off, and he would bring them back.”

Sebelius said she believes that once more people see the benefits of the law—such as parents who can now keep their children on their health insurance plan until age 26—it will prove popular.

Politics in the Genes

Sebelius began a career in politics because she wanted a part-time job. “I ran for office not to be in government, but to be home,” she said. “It was a part-time job, but it also gave me the opportunity to do something I cared about and have lots more time with my kids.”

The foundation of her civic involvement was established in her childhood, she said. Her father, John Gilligan, was a city councilman in Cincinnati, a congressman and the 62nd governor of Ohio. The two are the only father and daughter to have both been elected governors.

As a child, Sebelius thought that all families went door to door and put up yard signs every fall. “I grew up with the sense that that was a great way to participate in community life and to make a difference,” she said.

As health and human services secretary, one of the agencies Sebelius oversaw was the Centers for Disease Control and Prevention. She joked that she’d take difficulties with a website any day over dealing with the current Ebola epidemic. In assessing the CDC response to the disease, she said the agency probably made some overly confident statements about the health-care system being ready. Hospitals, she noted, have to be prepared to handle multiple emergencies—such as the recent health crises involving the H1N1 strain of flu and Middle East Respiratory Syndrome, or MERS—but the likelihood that they would have trained providers for Ebola was not high.

Decisions must be guided by science, which is difficult when people are afraid, she said. “It’s dangerous when politicians begin promulgating guidelines not based on science,” she said. “What’s important about this disease is that it has to be stopped in West Africa, and if it’s not, then we’re all in trouble.”

The Tisch College Distinguished Speaker Series will continue with political columnist Matt Bai, A90, on Nov. 5 and Boston Mayor Marty Walsh on Dec. 2. For information, go to http://activecitizen.tufts.edu/speakers.

Marjorie Howard can be reached at marjorie.howard@tufts.edu.