(Bloomberg) — The U.S. government needs to offset “misinformation” about the health care law being circulated in states led by Republican governors, according to the Obama administration official responsible for implementation.

Kathleen Sebelius, the secretary of Health & Human Services, said the Affordable Care Act will succeed in states run by Democrats who have embraced the law. In states such as Georgia where the governor and legislature are in Republican hands, “the job is made doubly difficult,” Sebelius said in an interview last week during a visit to Atlanta to meet with supporters of the law.

The comment further drives a wedge between the Obama administration and Republicans who have opposed the ACA and continue to undermine next year’s core implementation. Republicans in Indiana, Ohio, Georgia and Florida have said people who buy insurance for themselves face huge premium increases — as much as triple in Georgia, the state’s insurance commissioner, Ralph Hudgens, said on July 30.

“We know that there will be states where things will go very well because the states are all in,” Sebelius said. For residents in other states, “getting correct facts to them, drilling down through the misinformation, is going to be more complicated. That’s where a lot of my time and effort is going to be spent, on the markets that are really federal markets.”

Sebelius’s trip to Georgia is one of a series she’s making through the end of the year to encourage uninsured Americans to sign up for the ACA’s new coverage options.

Signing up

The government has said it wants at least 7 million Americans who don’t get health coverage at their jobs to sign up for plans by early next year in new insurance marketplaces set to open in every state on Oct. 1, 2013. In Georgia and 26 other states, the exchange will be run by the federal government with little or no involvement by state officials. Sebelius also traveled to Florida, where the state government also has opposed the health law.

In Congress, Republicans led by Senators Mike Lee of Utah and Ted Cruz of Texas have threatened to force a federal government shutdown unless Obama agrees to a fiscal 2014 spending plan that provides no money for the health law.

Sebelius said that campaign is folly.

Moving forward

“There still is a dialogue being perpetuated by some opponents that this is gonna go away, and that this is not the law,” she said. “The Affordable Care Act was signed in March of 2010, it was upheld by the Supreme Court a year ago, the president was re-elected and we will implement the law. This is the law; it’s not a debate any longer, it’s not a discussion.”

“We’re going to move forward,” she said.

In Atlanta, Sebelius met with the chairman of the Fulton County Commissioners, John Eaves, and a group that included local hospital executives and advocates for the health law. The county spends $50 million to $100 million a year on care for the uninsured, Eaves said, a burden that will be partially lifted by the health care law.

He plans to lobby Governor Nathan Deal, a Republican, to agree to a Medicaid expansion that would cover adults under the poverty level, who won’t be eligible for subsidies to buy insurance in the exchanges, Eaves said in a news conference after the meeting.

Georgia can’t afford its share of the Medicaid expansion, which would amount to 10% of the cost by 2020, a spokesman for Deal, Brian Robinson, said in an e-mail. The federal government picks up the entire cost of the expansion until 2017.

The Obama administration should instead agree to convert Georgia’s Medicaid payments to a “block grant,” he said.

“We could go a long way toward achieving the goals the secretary espouses without crippling the state’s budget,” he said.

25 million

About 25 million people are expected to gain coverage from the ACA by 2016, which includes the state exchanges and an expansion of Medicaid programs for the poor, according to estimates from the Congressional Budget Office. Sebelius said states like Georgia that have refused to expand Medicaid present “a big challenge” for enrollment efforts.

“Reaching consumers who may be desperate for health security, for health insurance, only to say to them if they’re below 100 percent of poverty, ‘you really don’t qualify for any financial help until the Medicaid expansion is adopted,’ is a very difficult message and I think will be hugely disappointing to a lot of people,” Sebelius said in the interview.

Georgia stands to miss out on about $40 billion in Medicaid funding over the next decade if it doesn’t expand, she said. That will be “frankly, very economically damaging on an ongoing basis to that state, where resources will continue to be poured into uncompensated care, hospitals will continue to look at a situation where they’re on the verge — which a lot of community hospitals are right now -- of very difficult financial times,” Sebelius said.

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