In a Washington Post opinion piece, HHS Secretary Kathleen Sebelius writes that the federal health reform law is designed to reduce costs "in three ways: by increasing insurance-market competition, assisting those who can't afford coverage and tackling the underlying cost of medical care." Sebelius notes that the reform law "also makes health plans more affordable for small businesses and individuals by creating a marketplace of state-based health insurance exchanges," adding that "the Affordable Care Act gives us tools to reduce costs by promoting better health and providing better care, especially in Medicare and Medicaid, which can be tremendous forces for positive change across the entire health care system."