Republicans Stretch the Truth on Obamacare Funding

U.S. Rep. Jack Kingston speaks U.S. Rep. Hank Johnson (D-GA) before President Barack Obama speaks to a small crowd at the Savannah Technical College March 2, 2010 in Savannah, Georgia. The President's visit is part of the White House's Main Street Tour where he meets with members of the community to share ideas for rebuilding the economy in an effort to spend some time outside of Washington and talk to American families about what they are experiencing during these tough economic times.
National Journal
Sarah Mimms
Add to Briefcase
Sarah Mimms
Jan. 21, 2014, 2:35 p.m.

When the ap­pro­pri­ations bill passed through Con­gress, Re­pub­lic­ans and Demo­crats both claimed vic­tory on pro­vi­sions re­lated to the Af­ford­able Care Act. Re­pub­lic­ans touted small cuts aimed at the law’s im­ple­ment­a­tion, while Demo­crats crowed that the law’s fund­ing was pro­tec­ted.

A closer ex­am­in­a­tion of the le­gis­la­tion shows a much more nu­anced out­come, in which Re­pub­lic­ans did get some of the cuts they wanted — just not all those they’re tak­ing cred­it for.

There’s ac­tu­ally very little ap­pro­pri­at­ors can do to stall the health care law, said Re­pub­lic­an Rep. Jack King­ston, who heads the House Ap­pro­pri­ations sub­com­mit­tee that deals with the Health and Hu­man Ser­vices De­part­ment.

Most of the fund­ing for the law is man­dat­ory, not dis­cre­tion­ary, leav­ing GOP ap­pro­pri­at­ors with few op­tions when it comes to de­plet­ing the law’s re­sources.

But King­ston said they cut what they could.

“The Obama­care bill when it was passed ac­tu­ally ad­vance-fun­ded its ap­pro­pri­ations and the man­dat­ory doesn’t come un­der our bill,” he said. “Any fund­ing that was channeled in­to im­ple­ment­ing Obama­care, we have cut.”

Demo­crats dis­agree, ar­guing that fund­ing for the law and its im­ple­ment­a­tion is nearly equi­val­ent to what Con­gress au­thor­ized in fisc­al 2013.

What ac­tu­ally happened is that Re­pub­lic­ans have said re­peatedly that the om­ni­bus spend­ing bill cuts $1 bil­lion from the Pre­ven­tion and Pub­lic Health Fund, a pro­gram with­in the Af­ford­able Care Act that is de­signed to provide fund­ing for pre­ven­tion and well­ness ini­ti­at­ives. While the bill provides the full $1 bil­lion re­ques­ted for the PPHF for the cur­rent fisc­al year, it also al­loc­ates those re­sources to spe­cif­ic dis­ease-pre­ven­tion pro­grams, pro­hib­it­ing the Obama ad­min­is­tra­tion from us­ing the fund­ing to off­set the costs of im­ple­ment­ing the health care law.

Wor­ried that HHS Sec­ret­ary Kath­leen Se­beli­us was us­ing it as a “slush fund” to provide ex­tra money to pay for im­ple­ment­a­tion, Re­pub­lic­ans in­cluded a pro­vi­sion that spe­cific­ally al­loc­ates every cent for fisc­al 2014 to a vari­ety of pre­ven­tion and well­ness pro­grams, in­clud­ing dia­betes, heart dis­ease, and can­cer pre­ven­tion pro­grams. The de­part­ment also has to ac­count for every trans­fer.

The move al­lowed law­makers in both parties to de­clare vic­tory.

Sen. Tom Har­kin of Iowa, King­ston’s Demo­crat­ic coun­ter­part on Sen­ate Ap­pro­pri­ations and the au­thor of the PPHF por­tion of the Af­ford­able Care Act, said this marks the first time Con­gress has fully ap­pro­pri­ated re­sources for the fund since the law passed in 2010. The fund was raided in 2012 to pay for the Medi­caid “doc fix” and in 2013 to help pay for en­roll­ment ef­forts un­der the health care law.

“As the au­thor of the fund, I con­sider the al­loc­a­tion of these re­sources to pre­ven­tion and well­ness as a ma­jor achieve­ment in this bill,” Har­kin said on the floor last week. Health care groups were also en­thu­si­ast­ic about the pro­vi­sion.

In terms of oth­er im­ple­ment­a­tion fund­ing, the bill does provide $2.5 bil­lion for “pro­gram op­er­a­tions” at the Cen­ter for Medi­care and Medi­caid Ser­vices, one of the primary ac­counts from which the ad­min­is­tra­tion has drawn im­ple­ment­a­tion funds. King­ston points out that the money is $1.5 bil­lion less than HHS re­ques­ted in the pres­id­ent’s 2014 budget. But the fund­ing for the pro­gram is ac­tu­ally set at ex­actly the same al­loc­a­tion HHS was giv­en in fisc­al 2013.

Still, Re­pub­lic­ans did get one clear vic­tory in work­ing to un­der­mine the Af­ford­able Care Act: The bill cut $10 mil­lion from the In­de­pend­ent Pay­ment Ad­vis­ory Board, a con­tro­ver­sial pro­vi­sion of the law. The board is charged with mak­ing bind­ing re­com­mend­a­tions to Con­gress for re­du­cing Medi­care costs be­gin­ning in fisc­al 2015, but it has been lam­basted by con­ser­vat­ives as a “death pan­el” and a bur­eau­crat­ic ex­er­cise.

Re­pub­lic­ans have touted the IPAB cuts, but Demo­crats have said little about the is­sue.

What We're Following See More »
THE PLAN ALL ALONG?
Manchin Drops Objections, Clearing Way for Spending Deal
1 days ago
THE LATEST

"The Senate standstill over a stopgap spending bill appeared headed toward a resolution on Friday night. Senators who were holding up the measure said votes are expected later in the evening. West Virginia Democrat Joe Manchin had raised objections to the continuing resolution because it did not include a full year's extension of retired coal miners' health benefits," but Manchin "said he and other coal state Democrats agreed with Senate Democratic leaders during a caucus meeting Thursday that they would not block the continuing resolution, but rather use the shutdown threat as a way to highlight the health care and pension needs of the miners."

Source:
UNCLEAR WHAT CAUSED CHANGE OF HEART
Giuliani Out of Running For State
1 days ago
BREAKING

Donald Trump transition team announced Friday afternoon that top supporter Rudy Giuliani has taken himself out of the running to be in Trump's cabinet, though CNN previously reported that it was Trump who informed the former New York City mayor that he would not be receiving a slot. While the field had seemingly been narrowed last week, it appears to be wide open once again, with ExxonMobil CEO Rex Tillerson the current favorite.

Source:
ALSO VICE-CHAIR OF TRUMP’S TRANSITION TEAM
Trump Taps Rep. McMorris Rodgers for Interior Secretary
1 days ago
BREAKING
SHUTDOWN LOOMING
House Approves Spending Bill
2 days ago
BREAKING

The House has completed it's business for 2016 by passing a spending bill which will keep the government funded through April 28. The final vote tally was 326-96. The bill's standing in the Senate is a bit tenuous at the moment, as a trio of Democratic Senators have pledged to block the bill unless coal miners get a permanent extension on retirement and health benefits. The government runs out of money on Friday night.

HEADS TO OBAMA
Senate Approves Defense Bill
2 days ago
THE LATEST

The Senate passed the National Defense Authorization Act today, sending the $618 billion measure to President Obama. The president vetoed the defense authorization bill a year ago, but both houses could override his disapproval this time around.

Source:
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login