More Details: Paying For Insurance Exchanges, Other Health Law Provisions

According to the Obama administration's 2014 budget document, the federal government will spend about $4 billion on federal- and state-run marketplaces for individual and small businesses purchasing insurance coverage.

Politico: HHS Seeks Obamacare Funds – But Is Ready To Scramble
The landmark health law may have survived the Supreme Court, countless repeal efforts and a presidential election — but none of that required Republicans to shower money on Obamacare. And with at least 33 states refusing to build the critical health insurance exchanges, the federal government is unexpectedly on the hook to set them up — and short of money to do so. The White House requested $1.5 billion more for the health law implementation in its budget Wednesday, but health officials know they're not likely to get it (Millman and Norman, 4/10).

The Associated Press/Washington Post: What Health Care Overhaul? Tracking Costs Of Obama's Health Law In Budget Isn't Easy
It turns out that the costs of the Affordable Care Act — Obamacare to its unyielding Republican foes— are sprinkled here and there through hundreds of pages of budget books. It's partly due to the arcane ways of government budgeting. It may also be an effort to avoid giving foes more of a target. ... Even some of the major spending in the new law isn't easy to find. Starting Jan. 1, people who don't have health insurance through their jobs will be able to get coverage in two main ways. Low-income people will be eligible for an expanded Medicaid program, provided their state government accepts. Uninsured middle-class people in every state will be eligible for subsidized private plans through new state health insurance marketplaces that go live online this fall (4/11).

Bloomberg: Obama Trims Details On Health Law As Exchange Cost Rises
The $1.3 trillion U.S. health-care system overhaul is getting more expensive and will initially accomplish less than intended. Costs for a network of health-insurance exchanges, a core part of the Affordable Care Act, have swelled to $4.4 billion for fiscal 2012 and 2013 combined, and will reach $5.7 billion in 2014, according to the budget President Barack Obama yesterday sent to Congress. That spending would be more than double initial projections, even though less than half the 50 U.S. states are participating (Wayne, 4/11).

Kaiser Health News: HHS Seeking $1.5B In Funding To Run Federal Health Insurance Exchanges
The Obama administration is trying once again to convince Congress to provide more funding for the health law's insurance exchanges, which are set to begin enrollment this fall. According to figures released in the fiscal 2014 budget request Wednesday, the administration estimates that the federal government will spend about $4 billion on those federal- and state-run marketplaces for individual and small businesses purchasing insurance coverage (Carey, 4/10).

The Hill: Cost Of Exchanges Doubles
Setting up insurance exchanges — the centerpiece of President Obama's healthcare reform law — is costing the Health and Human Services Department a whole lot more than it originally expected. According to budget documents released Wednesday, the department expects to spend $4.4 billion on exchange grants to the states by the end of this year — double its estimates a year ago (Baker and Viebeck, 4/10).

Politico: Obamacare Funding A Tough Sell With Congress
President Barack Obama’s 2014 budget sketches out his vision of a grand bargain on entitlements — and makes another stab at getting the funding needed to make sure the Obamacare exchanges are up and running late this year. The federal government is going to be responsible for putting up the new insurance marketplaces known as exchanges in 33 states — a task for Washington that was neither anticipated nor funded when the health law was passed in 2010 (Norman, 4/10).

CQ HealthBeat: HHS Using Several Sources To Fund Federal Health Insurance Exchange
Federal officials revealed long-withheld details Wednesday about how the Obama administration is funding the creation of an insurance marketplace critical to the success of the health care law and its coverage expansion provisions. Health and Human Services Department officials said they expect to spend some $1.5 billion in fiscal 2013 on the federal exchange (Reichard, 4/10).

The Associated Press/Washington Post: Obama Health Care: Cover Uninsured, Trim Medicare, Hike Tobacco Taxes
President Barack Obama's new budget offers Medicare cuts to entice Republicans into tax negotiations, while plowing ahead to cover the uninsured next year under the health care law the GOP has bitterly fought to repeal. But the biggest health consequences of any new proposal in Obama’s plan could come from nearly doubling the federal tobacco tax. If enacted by Congress, it could make young people think twice about the cigarette habit (4/10).

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