Search for ‘Obamacare’ Funding Angers Lawmakers

Margot Sanger-Katz

With money and time running out to implement the president’s health care law, administration officials are looking for funding wherever they can find it—and angering members of Congress along the way.

Republicans in Congress are fuming about recent reports that Health and Human Services Secretary Kathleen Sebelius has been calling private companies—including some that her department regulates—and asking them to help with private efforts to educate the public about the Affordable Care Act.

It’s one of several actions the department has taken recently to direct funds toward the massive effort that will be required to explain the 2010 health care law to uninsured people who will benefit and help them enroll in health plans starting in October. Getting those people to sign up is key to the law’s success, but it represents a major outreach challenge in the current fiscal and political climate.

The administration announced last week that it would be directing funds earmarked for expansion of community health centers toward outreach workers. In April, Sebelius disclosed that the department had diverted money from a dedicated Prevention and Public Health Fund to subsidize similar efforts.

The actions reflect the department’s failure to secure additional funding from Congress or cooperation from state governments to implement the Affordable Care Act, despite public polling that suggests very few people who will be eligible for new benefits are aware of it.

The news that Sebelius has been personally calling leaders of private companies to solicit their advice and donations for the nonprofit Enroll America, first reported by The Washington Post, set off a flurry of congressional outrage. The House Ways and Means and the Energy and Commerce committees have already launched separate inquiries. Sen. Lamar Alexander, R-Tenn., the ranking member on the Senate Health, Education, Labor, and Pensions Committee, has asked the Government Accountability Office to investigate.

On Tuesday, the Republican members of the Senate Finance Committee sent Sebelius a letter demanding a review of department actions. “Our initial reaction is that this appears at best to be an inherent conflict of interest and at worst a potentially illegal augmentation of appropriation,” it said.

Jason Young, a spokesman for the department, said Sebelius has stopped short of asking for donations from companies regulated by the department. But he confirmed that she has been reaching out to charitable foundations, businesses, churches, and individual providers and asking them to give to Enroll America, a group helmed by former Obama campaign and administration officials.

Young also said that the secretary has spoken to businesses that are regulated by the department, including health insurance companies, and asked them to provide advice and logistical support. Insurance companies have recently submitted bids to participate in the new state marketplaces, and are waiting for federal approval.

“We’re marching forward with building the public-private partnership that is needed to ensure a successful open enrollment,” Young said.

The department’s attempts to locate dollars for health care reform education and outreach haven’t just upset Republicans on the Hill. They have also angered key Democrats who feel the department is stretching the law by taking money from dedicated funding sources and diverting it to pay for implementation.

Sen. Tom Harkin, D-Iowa, chairman of the Health Committee and the Appropriations Health Subcommittee, was so angry about the use of prevention-fund money that he placed a hold on a top administration health official’s nomination, though he has since lifted it. The prevention fund was designed to cover efforts to improve pubic health. Harkin said that using the money to pay for administrative functions was like “robbing Peter to pay Paul.”

Sen. Bernie Sanders, I-Vt., a key proponent of the health centers, said he thinks the administration’s use of that money violates the spirit of the law, and he has voiced his concerns to the White House. The fund was designed to add new sites for Federally Qualified Community Health Centers, which provide primary care to underserved communities around the country. Last week, the department announced that it would devote $150 million from the fund to hiring outreach workers for the centers, not expanding health care delivery.

“We need to build the primary health care infrastructure,” Sanders told National Journal Daily. “Taking, as I understand, $150 million designed to expand community health centers and access points and putting them into another area is to me very, very disturbing and a real setback for what we had hoped to accomplish in strengthening primary care in America.”