It was a rough week on Capitol Hill for Health and Human Services Secretary Kathleen Sebelius. She appeared before congressional committees in the House and the Senate to defend President Obama’s proposed fiscal year 2014 budget, but spent much of her time fending off attacks on the Affordable Care Act (ACA).
She had a testy exchange with Rep. Michael Burgess (R-Texas), who is critical of how HHS has handled the Pre-Existing Condition Insurance Plan. The PCIP is a program that provides health insurance coverage for uninsured adults with pre-existing conditions and was scheduled to run until Jan. 1, 2014 when the ACA would require health plans to offer insurance regardless of prior medical conditions. But the program is short on funds, so HHS halted new enrollment in February.
HHS Secretary Kathleen Sebelius at the Senate Finance Committee hearing
Rep. Burgess is a cosponsor for a bill (H.R. 1549) that would infuse the program with $4 billion in new funding taken from the ACA’s Prevention and Public Health Fund. That’s where the controversy comes in. The GOP have frequently called the prevention fund a "slush fund" and tried to eliminate it by using the $15 billion in it for deficit reduction. And HHS officials, who oppose the bill, have been dipping into the fund to cover some ACA implementation costs that Congress has refused to fund, such as education and outreach for the new health insurance exchanges. Just to make it more confusing, some conservative groups, including the Heritage Foundation, said they oppose the plan to add funding to the PCIP, because they oppose federally-funded high-risk insurance pools.
Meanwhile, across town Ms. Sebelius was grilled by Senators about why her department wasn’t doing a better job getting the word out about the exchanges. Sen. Max Baucus (D-Mont.), a supporter of the ACA, said he was concerned the exchange implementation would be a "train wreck."
Hear about all these issues and criticism of Medicare’s electronic health record incentive program in this week’s edition of the Policy and Practice podcast.