Delayed regulations, implementation costs of the healthcare reform law, and mandated contraception coverage in health plans were among the top issues Thursday at a congressional hearing featuring HHS Secretary Kathleen Sebelius as the sole witness.
Appearing before the House Energy and Commerce Health Subcommittee to testify about the Obama administration's fiscal 2013 budget, Sebelius fielded a range of other questions about the Patient Protection and Affordable Care Act. Rep. Fred Upton (R-Mich.), chairman of the full Energy and Commerce Committee, asked the secretary why, for instance, Congress appropriated $1 billion to implement the healthcare law and the administration has requested another $1 billion in its most recent budget. Sebelius noted that the Congressional Budget Office in March 2010 estimated it would cost about $1 billion annually to implement the law.
“We have spent at HHS about $261 million—totaled with our other agency partners $475 million—but we think by the end of 2012 that original $1 billion will be spent, and two-and-a-half years will have expired,” Sebelius said. “So we are significantly under-spending" what the CBO estimate was.
Rep. Joe Pitts (R-Pa.) asked Sebelius about the status of certain regulations, particularly about a final rule for state insurance exchanges. Sebelius replied that such a rule is expected “shortly.”
“I don't know what shortly means,” Pitts said after the hearing. “There's only 18 months left, so you're really pressing the states, giving them a short opportunity to fully set up if you don't get that rule soon. And there's no rule,” he added. He also expressed concern that HHS has yet to release a rule on essential health benefits and said he doesn't expect one until after this year's elections.
On the same day the Senate rejected an amendment
that would create a conscience exemption in HHS' preventive services rule, Sebelius addressed a question from Upton about self-insured plans. She said the administration “will offer a variety of strategies” to ensure religious liberties are respected and millions of women have access to these services, and offered working with third-party administrators as one possibility.
“The third-party administrators for these companies that are self-insured just submit the bill, so what is she talking about?” Rep. Phil Gingrey (R-Ga.), a physician, said in an interview later. “Here's the bill: pay it. That's what they do.”