With a mandate by President Barack Obama to wrap up the more than yearlong debate on health care reform in this country, a top administration official said, “We are in the final chapter.”

Kathleen Sebelius

U.S. Department of Health and Human Services Secretary Kathleen Sebelius said after a number of hearings, discussions, debates, ideas and plans, the nation has two comprehensive health reform bills and is on the precipice of change.

“We have comprehensive legislation for the first time,” Sebelius said on ABC’s This Week March 7. “We are in the final chapter, mostly because the American people are desperate. They are caught in this world where they have no control over their insurance rates. They are seeing next week, next month, their rates rise enormously, and over and over again, people are losing their coverage.”

Sebelius, a former insurance regulator in Kansas, said despite the tug-of-war of words between Democrats and Republicans, there are agreements on core principals, but still spaces of great disagreement. One she highlighted was the Republican push for the sale of health insurance across state lines, an idea that does not have the support of insurance companies or the National Association of Insurance Commissioners (NAIC), which represents regulators across the nation.

“The Republicans feel strongly that insurance companies should have less regulation than they do now, less consumer protection, less oversight,” Sebelius said. “The president feels strongly that we need to change the rules of the road, that we can no longer have a private health system where insurance companies get to pick and choose, where they can lock people out and price people out. And that’s really one of the fundamental divides. And even though there are lots of Republican ideas in the bill. …We are hopeful that there will be Republican votes, but I’m not sure there will be.”

That point was driven home by Senate Minority Leader Mitch McConnell (R-Ky.), who said reform is not about the policy, the president or the Senate and House Democrats and Republicans, but, “It’s about the bill.

“The American people are focused on this like a laser,” he said. “Everybody is interested in health care. Obviously, when you get older, you’re more interested in it, but everybody is interested in it. The American people have been deeply involved in this debate. What did they see? They see a bill that cuts Medicare by half a trillion dollars, that raises taxes about half a trillion dollars, and that almost certainly will raise the cost of insurance for those on the individual market.”

McConnell said the public also sees the way health reform was passed, with promises to holdout legislators, trading favors for votes, “and they say they don’t want it.”

The Republican said it is his understanding that if the House passes the Senate’s version of the bill, it goes to President Obama for his signature, so lingering talk about a reconciliation bill is “kind of irrelevant.”