U.S. Health and Human Services Secretary Kathleen Sebelius warned on Tuesday that repeal of the health-care overhaul law would add to the federal deficit and bring back the "worst abuses of the insurance industry."

Her remarks came in a telephone press conference with regional reporters in response to a potential early vote by House Republicans to scrap the landmark Affordable Care Act. She said the agency would send Congress a letter on Wednesday showing how Americans are adapting to the first steps taken to carry out the law. (See below.)

She expressed confidence that the law would prevail because she says Americans are now seeing its benefits. She suggested that Republicans needed to have conversations with their constituents to appreciate those benefits. Republicans have argued that Congress overstepped its powers by enacting the law, and that the law itself would add to the deficit.

In Washington, incoming House Majority Leader Eric Cantor defended the GOP's upcoming effort to repeal the health-care law, reported the Washington Post, saying, "The American people are expecting quick action from the Republican majority."

Sebelius said legal challenges are likely to end in a series of "mixed rulings" over years. She added that two key rulings so far have sided with the law. Another took issue with one provision, the insurance mandate, but did not call for a complete dismantling of the law. She said the Congressional Budget Office's study found that the law would save $1 trillion, adding that the number refutes GOP arguments that the law would add to the deficit.

"There is no question that repeal would be a huge step backward that we can't afford," she said.

She said her agency would distribute state-by-state data later today on how the law has benefited individuals, families, seniors and small businesses. She says the data would "show what will happen if Republican leaders in Congress got their way and the law was repealed."

She singled out Blue Cross Blue Shield of Kansas City as an example of how the new law had brought relief to businesses and workers. The insurer, she said, had already enrolled more than 9,000 new members who are insured through 400 employers. About one-third of the new members didn't have health coverage before, she said, and have it now because of tax credits that make it possible for small businesses to help workers get health coverage.

In her home state of Kansas, she said, 50 employers and unions have been able to maintain health coverage for early retirees because of the act's early retiree reinsurance program.

"If repeal succeeds, it would put care for those retirees in serious jeopardy," she said. She said repeal also would mean 16,000 young Kansans would lose health insurance under their parents' health plans

"We know that countless people would continue to see their premiums rise without new rules that now limit the amount of health-care premium dollars that insurers can spend on administrative costs, like marketing and CEO salaries," she says.

She added that 30,000 seniors in Kansas had received $250 checks to cover the so-called doughnut hole in prescription drug coverage. This year, she said these seniors would get 50 percent discounts on brand name drugs.

"Repeal would take tax credits away from 4 million small businesses," she said, adding that "what's happening in Kansas we can see replicated across the country. We can't afford to take benefits away from families, to bring back all of the worst practices of the insurance industry, to deny coverage to 32 million and add a trillion to the deficit by the end of the next decade."

She said Republicans needed to look at the evidence that "reforms are working for millions of Americans." She said HHS would continue carrying out the law and added, "What we intend to do is focus on continuing to implement the law effectively, improving it where we can."

Effect on Missouri

According to the Department of Health and Human Services, repeal of the Affordable Care Act would adversely affect Missourians in many ways, including the following:

• 20,000 young adults would lose insurance that the law allows them to receive through their parents' health plans.
• Nearly 3.3 million residents with private insurance would be vulnerable again to having lifetime limits on their health insurance.
• Insurers no longer would need to comply with the new law's requirement that they spend at least 80 to 85 percent of premium dollars on health care and less for corporate profits, CEO salaries and bonuses.
• New insurance plans would not be required to cover recommended preventive services, such as flu shots, without cost sharing.
• 961,000 seniors in Missouri with Medicare would have to pay for an annual health check-up. They may be required to make a co-payment to get preventive services, such as mammograms and colonoscopies.

In addition, the agency says repealing the law would mean that Missouri no longer would receive additional resources for:

• A consumer program to crack down on unreasonable insurance premium increases.
• An insurance exchange expected to lead to one-stop insurance shopping for the best benefits and protections at lower costs.
• An Early Retiree Reinsurance Program to help early retirees and their families continue to have quality, affordable health coverage when a company discontinues coverage.

Also on Tuesday, the Small Business Majority released a poll showing that the health-reform law would make most of them more likely to provide health insurance for their workers.

The organization, a national nonprofit advocacy group for small businesses, said the survey included 619 business owners with fewer than 50 workers. It said 33 percent of businesses that don't offer insurance said they'd be more likely to do so because of the tax credits.

To qualify for the credits, the businesses must have fewer than 25 workers whose average annual wages must be under $50,000. The law allows small businesses to get tax credits of up to 35 percent of their health insurance costs, beginning in the 2010 tax year.

"These findings are very encouraging," said John Arensmeyer, CEO of Small Business Majority.

The poll found that only 31 percent of small business owners were familiar with the insurance exchanges. Insurance exchanges, which go into effect in 2014, will allow small businesses and individuals to band together to buy insurance. Among the survey's other findings:

• 33 percent of respondents said they would be more likely to offer health insurance because of insurance exchanges.
• 31 percent said the tax credits would make them more likely to continue providing insurance.