Baucus: HHS' Lack of Guidance on ACA Could Lead to 'Train Wreck'


During a hearing on Wednesday, Senate Finance Committee Chair Max Baucus (D-Mont.) warned HHS Secretary Kathleen Sebelius that her department has not adequately informed the public and small businesses about the Affordable Care Act, which could result in a "train wreck" during its implementation, the New York Times' "The Caucus" reports.

Hearing Details

Baucus cited a Kaiser Family Foundation poll last month that found large percentages of respondents believe inaccurate information regarding the ACA's provisions. He said, "I'm concerned that a lack of clear information is leading to misconceptions and misinformation, and people generally dislike what they don't understand," adding that he would give the administration's outreach efforts so far a "failing grade."

Sebelius responded that the agency takes public education "very, very seriously," but she did not provide the lawmakers with specific details on planned outreach efforts (Wheaton, "The Caucus," New York Times, 4/17). She noted that the administration plans to roll out a large-scale public education campaign this summer and that the government is "on track" to begin enrollment in the ACA's health insurance exchanges this October (Alonso-Zaldivar, AP/Sacramento Bee, 4/17).

Sebelius said she expects public understanding of the ACA to improve with the deployment of exchange "navigators" this summer. She added that the navigators will focus on the 26 states that opted for a federally run exchange (Daly, Modern Healthcare, 4/17).

Sebelius also criticized GOP lawmakers for rejecting a $1 billion funding request earlier this year to help finance an outreach campaign (Morgan, Reuters, 4/17).

Small Business Concerns

During the hearing, Baucus said he especially is concerned about small businesses having misgivings about the ACA and about a delay in the implementation of the Small Business Health Option Program (Reichard, CQ HealthBeat, 4/17).

Earlier this month, the Obama administration said it is delaying until 2015 implementation of SHOP -- an ACA provision originally intended to give small businesses multiple health plan options starting in 2014 -- because of operational challenges and the need for additional time to prepare (California Healthline, 4/2).

Sebelius clarified that SHOP exchanges will be open for small businesses in every state beginning in January 2014. However, in states with a federally run exchange, employees will not be able to use the exchanges separately from their employer until 2015 --- and then only if the employer allows them to. In areas with a state-run exchange, some employees will be able to use the SHOP exchanges during the first year of their implementation, she noted (CQ HealthBeat, 4/17).

Rose King
It would be refreshing to see national leadership ensure some uniform, standardized procedures instead of the usual chaos and cost of every state reinventing the wheel on every fine detail. Likewise, Governor Brown could exhibit state leadership and save time and money for California counties by developing efficient models for public safety and mental health realignment. This posturing about "local control" is an excuse for the state's weak or absent management--a posture established by Brown's earlier predecessor Governor and President Reagan.
Frank Neuhauser
I am always surprised when Sen. Baucus raises concerns about ACA and complexity. Baucus was able to negotiate (extort?) a huge Medicare increase for Montana hospitals and doctors. Baucus had the legislation apply a geographic adjustment that applied to only MT, WY, ND, & SD, that will cost taxpayers billions over the decade. The change increased payments for the wage component of Medicare reimbursement about 18%, but just for the narrow set of providers in his home state and 3 neighboring states. The negotiations over the final vote from the Senator from Nebraska got all the press at the time. But, Baucus got there earlier and got more for his states doctors and hospitals.

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