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The law provided vast amounts of money -- $1 billion -- for individual States to set-up their own health insurance exchanges, but no one knew that three dozen states would refuse to do that.
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Robbing Peter to Illegally Pay Paul:
The Obamacare Run Around Congress

Brett Norman & David Nather,
The Obama administration is dropping some new hints about how it has moved money around to fund Obamacare without Congress -- but not nearly enough to put the controversy to rest.

Forced to reveal more details under a provision tucked in this year's bipartisan budget deal, the Department of Health and Human Services declared Friday how it used Secretary Kathleen Sebelius's authority to move about $1.6 billion in departmental funds around last year -- the Cabinet secretary's version of looking for change under the couch cushions and hitting the jackpot.

But HHS didn't say exactly how it spent the money, and it didn't lay out the kind of detail Republicans sought. So now the Republicans will have to decide their next move, whether it's just more records requests or new efforts to tie the Obama administration's hands in future appropriations bills.

And even though it will be able to get some money from fees on insurers' selling plans on in future years, the Obama administration will still have to decide how it can keep Obamacare afloat if Congress keeps refusing to provide new funding.

Here are the lessons from Friday's report:

What we know: The big reveal is no surprise: The Obama administration got most of the money last year from Sen. Tom Harkin's cherished Prevention and Public Health Fund. But the report also told us more about the other couch cushions -- as the administration pulled money from various all-purpose department funds to help launch the law's new health insurance exchanges.

A one-page table from the official explanation of the administration's HHS budget shows that federal officials diverted more than $450 million from that prevention fund -- which Republicans call a "slush fund" -- to finance Obamacare work, including building

They also pulled $300 million from something called the Non-Recurring Expenses Fund, an account that allows an agency to use money left over from prior years for one-time expenses.

And they found $268 million from the general program operations account at the Centers for Medicare & Medicaid Services -- the main agency within HHS that's implementing the health law -- plus another $113 million from Sebelius's "transfer authority."

The numbers appear on page 349 of the budget justification, which lays out the reasoning for President Barack Obama's latest budget request. It's there because the omnibus spending bill signed in January required HHS to use that report to detail its Obamacare spending.

What we don't know: The report doesn't say anything about how the money was spent -- just where it came from. It also doesn't say how much more there might be from the sources that have been tapped before. That's likely to make Republicans re-up their demands for greater transparency.

Republicans have pressed for detailed information on the contracts issued for Obamacare implementation and the personnel used to do the work, particularly on the botched rollout and the subsequent website salvage mission. The new report gave them exactly nothing on that score.

"In their half-hearted attempt to respond to Senate language requesting detailed Affordable Care Act expenditures, the administration refused to reveal how much was spent on specific activities and projects," Kansas Sen. Jerry Moran, the top Republican on the appropriations subcommittee responsible for HHS, said in a statement. He said he was disappointed in the "budgetary smoke and mirrors" of the new accounting.

Rep. Michael Burgess of Texas, a top Republican on the House Energy and Commerce Committee, said the new disclosures appeared to be "more repackaging of the same kind of inadequate information we've gotten before."

CMS spokesman Aaron Albright said the agency's account of the funding for its exchange work "is consistent with the law and reported in a format consistent with precedent and other routine budget requests."

It's also not clear how much of a special, $1 billion Obamacare implementation fund remains, if any.

When passed four years ago, the ACA included just $1 billion for HHS for actual implementation -- an amount that advocates warned would be inadequate for legislation intended to make sweeping changes to a sector that makes up one-sixth of the US economy.

The law provided vast amounts of money for the states setting up their own health insurance exchanges, but no one knew at the time that three dozen states would refuse to do that and rely on the federal exchange instead.


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