Usually President Obama includes an Obamacare wish list in his annual budget proposal — but not this year.
The budget proposal released by the White House on Monday would continue to fund the Affordable Care Act, whose biggest components have now been in place for more than a year. But while in past years Obama has asked Congress for more money to fund the law’s health insurance marketplaces, the administration says they’re now on track to become financially self-sustaining.
The user fees now make up about 70 percent of the costs to run the marketplaces, said Andy Slavitt, deputy administrator of the Centers for Medicare and Medicaid Services — although officials noted that those fees can’t legally be used to operate the federal data hub that supports healthcare.gov.
Slavitt said he expects that share to keep growing as more insurers choose to participate in the exchanges where low- and middle-income Americans can collect health insurance subsidies.
And now that most of the exchanges’ infrastructure is up and running, fewer funds are needed to buy expensive technology, Slavitt said. He said this year, CMS is asking for $200 million less to fund IT efforts in this year’s budget proposal.
“Getting the program to third, fourth year and the stabilizing of user fees, I think we’ll see a really sustainable path for funding the exchanges going forward,” Slavitt told reporters on Monday.
The request for more exchange funding has typically been a sharp sticking point between the administration and Republicans.
Officials, who were originally provided with $1 billion to implement the law, said they needed more money than that to put it in place — and the Congressional Budget Office agreed, estimating that $5 billion to $10 billion would be needed to get it off the ground. President Obama had asked for another $1.5 billion to go towards implementing the law in 2015.
Just launching healthcare.gov cost $840 million, a Government Accountability Office report found last year. That includes more than $150 million in cost overruns for the version of the website that failed badly and had to be fixed.
Ever since the healthcare law was passed, the GOP-led House has refused to put more money towards a law Republicans didn’t approve of in the first place.
So officials have said they shifted money around to cover the costs, taking funds from other programs, an expense fund containing dollars left over from past years and a prevention and public health fund authorized by the healthcare law itself.
And on Monday, they said that’s tided things over to the point where now it may soon be funded entirely by the user fees.
“The need for federal dollars to implement the exchanges will be less as the years go on,” said Ellen Murray, Health and Human Services’ assistant secretary for financial resources.
