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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As GOP Seeks Cuts To Child Nutrition Programs, Democratic Rep. Pushes To Expand School Lunches

Republican budget proposals have included deep cuts to social safety net programs, including those that are aimed at ensuring that needy children have access to nutritional food at school. Last year’s House Republican budget, for instance, would have kicked 280,000 children out of the program, and spending cuts that have been enacted have targeted it too.

Amid those efforts, though, Democratic Rep. Dina Titus (D) is pushing in the opposite direction. School lunch programs provide breakfast and lunch to children when they are in school, but they leave many children without food options on weekends and holidays during the school year. Titus wants to fix that by expanding the program through the Weekends Without Hunger Act, which she introduced last week and rolled out in her Las Vegas district Thursday.

That the Republican budget seeks to cut such programs is a statement of “how out of touch it is with our nation’s needs and priorities,” Titus told ThinkProgress in an email.

“With 50.1 million American living in food insecure households, including 16.7 million children, it is our responsibility to protect programs such as free and reduced school lunches, SNAP, and WIC that these families rely on every day just to get by,” Titus said. “The federal budget is a statement of our national priorities, and providing funding for nutritious meals to ensure that vacation from school does not mean hunger for children is one of my top priorities.”

The legislation is co-sponsored by Reps. Marsha Fudge (D-OH), Zoe Lofgren (D-CA), and Terri Sewell (D-AL) and is one of several efforts to expand child nutrition programs. Iowa Sen. Tom Harkin (D) has introduced a bill that would expand those programs to child care centers in an effort to get food to more low-income children.

The Great Recession drove up the number of children living in poverty, adding to the number of children who live without enough food. Nearly 15 percent — more than 17 million in total — American households were food insecure in 2011, meaning they had difficulty providing food at some point in the year. There are 20 million students who benefit from free and reduced lunches at school, and another 10.5 million who are eligible but don’t receive the benefits.

The school lunch program gets food to children during the week, but weekends and holidays create gaps that leave many hungry. “While school meals help keep children healthy and ready to learn during days that school is in session, there is currently no targeted Federal child nutrition program available to provide these children with food during the weekend or extended holidays when they do not have access to school meals,” a release from Titus’ office said when the bill was introduced. “Vacation from school should not mean hunger for children.”

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