He pressed Sebelius for timeframes and benchmarks to demonstrate progress in implementing the law. But most of her department's implementation benchmarks are linked to the success of enrollment later this year, she said.
“We are on track to fully implement the marketplaces in January 2014 and be open for open enrollment,” Sebelius told reporters after the hearing.
Sebelius defended the administration's earlier decision to delay for one year a component of the so-called SHOP exchanges for small businesses. Small-business employees will have to use whatever subsidized insurance coverage is selected by their employers through the Small Business Health Options Program, but employees will have to wait to select their coverage until 2015.
Meanwhile, Sebelius partially blamed the lack of public knowledge about the law on Congress' rejection of $1 billion for the law's implementation that the administration requested as part of the end of the year spending deal. She said some of that funding was slated to go to public “outreach” regarding the exchanges and other provisions. The administration requested $1.5 billion in such funding in the president's recently released budget.
Also, Sebelius anticipates that $54 million slated for navigators, who will be paid to help connect people with insurance options—such as exchanges coverage—will improve public understanding and functioning of the exchanges.
“People will be on the ground this summer,” Sebelius said.
However, Sebelius said it is unknown how many navigators will be hired but specified that they would focus on the 26 states with federally operated exchanges. Another seven states will have marketplaces at least partially operated by the federal government. The administration's budget also drew bipartisan criticism for many of the $400 billion in 10-year healthcare cuts it included.
For instance, Sen. Robert Menendez (D-N.J.) said he was concerned that many of the drug cuts in the budget would result in reduced pharmaceutical research and increased costs for consumers. The budget would derive $169 billion of the $400 billion in reduced Medicare spending over a decade from various pharmaceutical cuts.
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