HHS chief sees mixed bag of challenges to implementing health care law

The nation's top health official hinted that the health care reform law would eventually wind up on the Supreme Court's docket and predicted that enrollment would grow next year in two of its signature programs.

Health and Human Services Secretary Kathleen Sebelius, in a conference call with reporters, said that the Obama administration has braced for a mixed bag of opinions on the constitutionality of the 8-month-old law. "Right now, where we stand on court decisions, two federal judges have found the individual mandate and the rest of the law constitutional," she said.

Last week, however, a federal judge in Virginia ruled that the requirement for all Americans to purchase health insurance was outside the bounds of the Constitution, but he allowed the rest of the package to move forward.

"[We're] likely to see a variety of opinions as we travel toward the Supreme Court," Sebelius said.

The secretary said she expects enrollment to grow in two of the law's earliest programs: one that establishes a coverage option for Americans who have a preexisting condition, and another that aims to help small businesses cover the cost of care for workers who retire early but are not yet eligible for Medicare.

Both programs were highly touted by HHS, but enrollment has been slower than expected. Sibelius, however, said that enrollment should increase as the department continues to stress the new benefits.

Sebelius spoke to reporters as part of a year-end update on the implementation timeline of the reform law. On Tuesday, HHS is expected to release what could be its final major proposal for 2010-guidelines to help define what is, and isn't, considered "unreasonable" when it comes to premium cost increases.

Next year, seniors will have access to free screenings for some types of cancer and will receive a 50 percent rebate on prescription drugs when they hit a gap in their Medicare coverage known as the "doughnut hole."