Sebelius Seeking Private Donations To Support ACA Implementation
Faced with lower-than-expected funding to implement the Affordable Care Act, HHS Secretary Kathleen Sebelius has been soliciting donations to a campaign headed by Enroll America, a not-for-profit coalition of groups focused on implementing and raising awareness about the ACA, the Washington Post's "Wonkblog" reports.
About the Solicitations
According to "Wonkblog," the solicitations -- of industry executives, community organizations and church groups -- have been confirmed by an HHS official and an industry representative familiar with Sebelius' requests (Kliff, "Wonkblog," Washington Post, 5/10).
Sebelius began placing the calls in late March, officials said. According to Reuters, HHS and the White House launched private-sector efforts after congressional Republicans signaled that they would reconsider allocating new funding to cover the federal government's outreach initiatives (Morgan, Reuters, 5/11).
For example, Senate appropriators in March released a broad-ranging substitute amendment to the House-approved continuing resolution extension bill that omitted additional funding for the implementation of the ACA (California Healthline, 3/21).
The uncertainty about the funding led HHS to reallocate hundreds of millions of dollars from programs not meant for ACA implementation efforts, "Wonkblog" reports.
Ellen Murray -- assistant secretary for financial resources at HHS -- said the department also had requested $1.5 billion for fiscal year 2015 to build and run dozens of insurance exchanges, "but we didn't receive any additional funding for the exchanges. So we've had to come up with a Plan B. We've been working very hard to develop that" ("Wonkblog," Washington Post, 5/10).
Sebelius' calls to stakeholders are expected to generate tens of millions of dollars, including as much as $10 million in donations from the Robert Wood Johnson Foundation and $500,000 from H&R Block, the New York Times reports.
Some Industry Execs, Republicans Express Discomfort, Opposition With Donation Requests
According to the Times, some health industry executives have expressed discomfort with Sebelius' donation requests, noting that the federal government is authorized to approve or reject health plans on federal health insurance exchanges in 30 states (Pear, New York Times, 5/12).
Meanwhile, Republicans have criticized the requests and suggested that they might be in violation of a federal law that prohibits federal officials from fundraising in their professional capacities (Baker [1], "Healthwatch," The Hill, 5/11).
Sen. Lamar Alexander (R-Tenn.) -- ranking member of the Senate Health, Education, Labor and Pensions Committee -- said Sebelius' solicitations should stop immediately because they appear to be violating the Anti-Deficiency Act, which bans federal departments from making greater expenditures in a fiscal year than those provided by Congress. Alexander added that Sebelius might be raising funds from "those she regulates" (Zigmond, Modern Healthcare, 5/11).
He said Sebelius' fundraising efforts "should cease immediately and should be fully investigated by Congress" (Baker [1], "Healthwatch," The Hill, 5/11).
Meanwhile, Sen. Orrin Hatch (R-Utah) -- ranking member of the Senate Finance Committee -- called the solicitations "absurd" and pledged to investigate the matter (Reichard, CQ HealthBeat, 5/10). Hatch added that he will seek "more information from the administration about these actions to help better understand whether there are conflicts of interest and if it violated federal law" (Baker [2], "Healthwatch," The Hill, 5/11).
HHS Defends Sebelius' Solicitations
HHS spokesperson Jason Young maintained that Sebelius' actions are not illegal or improper, noting that she has not made fundraising requests to groups regulated by the department (Baker, "Healthwatch," The Hill, 5/12).
Young said, "The secretary has been working with a full range of stakeholders ... We have always worked with outside groups, and the efforts now ramping up are just one more part of that work." He added, "There is a special section in the Public Health Service Act that allows the secretary to support and to encourage others to support non-profit organizations working to provide health information and conduct other public health activities" (Reuters, 5/11).
According to "Wonkblog," Department of Justice regulations state that Cabinet members can solicit donations as private citizens as long as they do not use official titles or "solicit funds from a subordinate or from someone who has or seeks business with the department" ("Wonkblog," Washington Post, 5/10).
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