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I find it so toxic and so difficult," she said. "When I was running in Kansas, Kansas really had two Republican parties. A much more conservative antigovernment party and a more moderate branch of the party. The two branches fought with one another more than they fought with Democrats.

Could we have used more time and testing? You bet. I’ve said that from the start,” “But the site actually works. And the great thing is, there’s a market behind the site that works even better. People have competitive choices and real information for the first time ever in this insurance market.”

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I think what we said from the outset was, you know, this was fixing a very broken market– where individuals really were on their own,” she said. “If you were healthy and wealthy, you could get coverage. If you weren’t, you were pretty much on your own”

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Women candidates were certainly running for statewide office in various places, but it was a tricky balance," she said. "You couldn't be too tough or people hated you. You couldn't be too weak or people thought you couldn't do the job. You were a witch or a bitch. It was a very complicated role to play.

My father went into politics when I was 5 years old," Sebelius said. "I did think that's what families did in the fall — go door to door and put up yard signs. I didn't know it was a volunteer activity. In our family, it was mandatory service.

That relentless battle is still underway,” Sebelius said. “The march toward universal coverage, as slow, difficult, and painful as it is, will continue in the United States of America, and I’m just delighted I had a small part in that wonderful march toward equity.”

A fruitful area of inquiry for researchers would be to measure whether public opinion favors incremental health care fixes or sweeping reform. Radical change would be counterproductive were it to a spark a backlash with the potential to undo hard-won gains,