Health and Human Services Secretary Kathleen Sebelius said she underestimated how long the politics of health reform would last and didn't anticipate how much confusion the slow rollout of the legislation would create.

Sebelius said she had expected the Supreme Court ruling and President Barack Obama's reelection would tamp down some of the "relentless and continuous" politics. But the controversy goes on.

"We find ourselves still having sort of state-by-state political battles," which is creating confusion about what benefits people can access and how, particularly in states where governors have been vocal about not participating in the law, she said. "So getting that word out and setting up the infrastructure has been more complicated," she said at the Harvard School of Public Health on Monday.

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