HHS Seeks Obamacare Funds — But Is Ready To Scramble

Here’s today’s billion-dollar question: Are Republicans going to allow the administration to spend more money on Obamacare?

Don’t count on it.

Continue Reading The landmark health law may have survived the Supreme Court, countless repeal efforts and a presidential election — but none of that required Republicans to shower money on Obamacare. And with at least 33 states refusing to build the critical health insurance exchanges, the federal government is unexpectedly on the hook to set them up — and short of money to do so. 

The White House requested $1.5 billion more for the health law implementation in its budget Wednesday, but health officials know they’re not likely to get it.

As past funding requests have been spurned, Health and Human Services officials contend they’ve been able to cobble together the funds and won’t miss the Oct. 1 start of open enrollment in exchanges. Any big delay, or major hitches would be a huge blow to Obamacare and reopen the law to  political warfare before the 2014 mid-term elections.

“The Supreme Court has ruled, there has been an election, we intend to implement the law,” HHS Secretary Kathleen Sebelius told reporters Wednesday.  She acknowledged that without an infusion of new money, she’s probably going to have to keep juggling and scrambling to keep it all on track.

HHS to date hadn’t been very specific about how it’s been moving ahead — even when lawmakers asked. But Sebelius told reporters that the department hadn’t yet spent the full $1 billion that was initially allocated for implementation — a figure that was decided on long before the states balked at exchange-building. Sebelius said the department had been  “judicious” in spending it, and officials said approximately $235 million is left in that fund.

In addition, like other Cabinet secretaries, Sebelius has some discretion over certain department accounts, and she has also dipped into a public health and prevention fund that’s part of the health law.

The money for the 17 states and Washington DC doing their own exchanges isn’t such a challenge: The health law basically gave them a blank check. HHS expects to send out another $4 billion in exchange grants between the 2013 and 2014 fiscal years.

Republicans have declined requests for more implementation money repeatedly. Just a few weeks ago they refused to add nearly a billion dollars to the latest continuing resolution — and the Democratic-led Senate didn’t push the issue.

HHS is getting used to searching for alternatives.

“We’ve had to come up with Plan B and we’ve been working very hard to develop that,” HHS Assistant Secretary for Financial Resources Ellen Murray told the Wednesday afternoon briefing.

Even when the law was passed three years ago, $1 billion for implementation was thought to be just the start. Getting the massive law up and running was expected to cost 10 times that. And that was before the federal exchange task ballooned as conservative states refused to do much to make the law a success.

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