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Harkin Accuses Administration Of ‘Robbing Peter To Pay Paul’

A Democratic senator chastised the White House Thursday for raiding the health law’s Prevention and Public Health Fund to pay for a program to help the uninsured sign up for coverage in new insurance marketplaces.

“This is robbing Peter to pay Paul,” Sen. Tom Harkin, D-Iowa, chairman of the Senate Health, Education, Labor, and Pensions Committee, told a senior official at the Centers for Medicare & Medicaid Services. “We’re not going to do that.”

The public blow-up underscored the administration’s challenge to find money to set up the 33 federally run or partnered marketplaces — the key way the federal health law is attempting to provide health insurance coverage to about 27 million people by 2016.

On Tuesday, the administration announced that $54 million would be made available to community groups in those states to help people sign up for insurance in the new online marketplaces that open for enrollment Oct. 1.  As it turned out, that money came from the law’s prevention fund, a part of the law that Harkin has championed.

The administration has struggled to finance some of the marketplaces because of how the law was written.  Congress gave states broad financial assistance to set up the marketplaces. But only 17 agreed to run them. No separate pot of funding was set aside for the federal or state partnership exchanges now being developed in the majority of states. Resources for those efforts have been further constrained because of the spending cuts imposed by budget sequestration.

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“This is above your pay grade, but I’m sending a message to those above you through you,” Harkin told Gary Cohen,  director of the Center for Consumer Information and Insurance Oversight. “We’re not going to accept that. I believe the navigators need to be funded but to rob it from the prevention fund? That doesn’t go, and it’s not going to go. So I just want to make that very clear.”

The back and forth occurred one day after the Obama administration requested $1.5 billion to set up and run the marketplaces as part of its 2014 budget blueprint – funds not likely to be approved by the Republican-controlled House.

The Prevention and Public Health Fund has been pillaged by both parties.  President Barack Obama has repeatedly endorsed cutting its budget as a means to reduce the deficit, while Republicans have voted to repeal it or failing that, use the money for other purposes. The fund originally included $15 billion over 10 years but last year, Congress cut $5 billion to extend the payroll tax holiday.

Harkin said the administration had assured him then that no additional money would be pulled.