Sebelius insists insurance exchanges will be ready

HHS Secretary Kathleen Sebelius again assured federal lawmakers that the health insurance exchanges will be ready for enrollment this fall, and also said her department does not have a contingency plan in place if HHS doesn't achieve that goal.

Sebelius told members of the House Energy and Commerce Health Subcommittee that HHS is focused on getting the exchanges—a major provision of the 2010 Patient Protection and Affordable Care Act—"up and running" after Rep. Michael Burgess (R-Texas), the panel's vice chairman, asked if HHS has a back-up plan in place.

"You've had three years and billions of dollars, and you are not ready," Burgess said. "I think Congress needs to hold your agency accountable," he said, adding that federal lawmakers would have to consider seriously putting any additional money into the exchanges if they are not ready to launch next year.

"I think the CBO analysis when the bill was passed was that we'd need about $10 billion in implementation money; $1 billion was appropriated," Sebelius said to Burgess toward the end of the two-hour hearing on the Obama administration's proposed fiscal 2014 budget. "I can tell you we are on track," she added. "We have judiciously used those resources, and we intend to be open for open enrollment around the country October 1."

That was the same message Sebelius delivered Wednesday before the Senate Finance Committee and repeated a few times throughout Thursday's hearing.

Sebelius also fielded questions from members, including one from Rep. Gus Bilirakis (R-Fla) about constituent concerns that their insurance premiums will increase under the law.

"The insurers right now, Congressman, are just beginning to file their plan rates for the new marketplaces," Sebelius said.

"There is a negotiation period either at the state level or with the federal marketplaces about what those rates are, so I think any description of what people will be paying is just invented at this point," she continued. "The rates are not filed. They are not certain, and we are very confident that—not from our standpoint, but from the Congressional Budget Office analysis—that the combination of competition, elimination a lot of the overhead costs and subsidies available to a lot of these Americans who for the first time will have full insurance coverage, they will be looking at a much more competitive rate and lower prices than they're paying right now if they have insurance coverage."

The House hearing also provided another opportunity for Republicans to criticize the controversial Affordable Care Act and Democrats to praise it. Burgess asked Sebelius about the use of funding from the law's prevention and public health fund—which he later likened to a "bank book" from which the secretary can withdraw funds—to advertise the benefits of the law.

"We are going to reach out to people who currently have no health insurance and who are under-insured or uninsured and inform them about the benefits of the Act," said Sebelius, who added that HHS has transferred about $332 million from the prevention fund for outreach activities.

On Wednesday, the Energy and Commerce Committee passed legislation that would take $4 billion from that prevention fund to help pay for the Pre-Existing Condition Insurance Plan, a temporary plan that the law established to provide coverage for Americans with pre-existing conditions. HHS suspended enrollment in the plan, which was intended as a bridge until the 2014 coverage expansions, in February.

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