WASHINGTON The White House announced a new $150 million initiative on Thursday to get uninsured Americans covered under President Barack Obama's healthcare reform law, as Republicans raised the volume on their calls for "Obamacare" to be repealed.
The enrollment program will funnel money to about 1,200 community health centers to hire and train thousands of workers who will help people obtain coverage through new subsidized online marketplaces and an expanded Medicaid program for the poor.
U.S. Health and Human Services Secretary Kathleen Sebelius also announced that she and other officials will travel the country to promote enrollment, as part of a larger public education and media campaign to begin this summer.
Public outreach is key to the success of Obama's landmark Patient Protection and Affordable Care Act because Democrats could be at risk in next year's congressional midterm elections if enrollment does not go well later this year and in early 2014.
But with the administration preparing for its summer campaign, Republicans have begun cranking up their opposition message machine.
House of Representatives Speaker John Boehner and Senate Republican leader Mitch McConnell sent Obama a letter on Thursday saying they would not participate in picking members of a controversial panel called the Independent Payment Advisory Board, or IPAB, which the reform law created to recommend ways to restrain Medicare spending if program cost growth exceeds set targets.
"We believe Congress should repeal IPAB, just as we believe we ought to repeal the entire healthcare law," Boehner and McConnell said in their letter.
House Republicans, who have voted to repeal or cut funding for the law three dozen times, intend to vote again next week on another repeal that is expected to pass the House. As before, that effort will go nowhere in the Democratically controlled Senate.
Both the letter and the vote are largely symbolic but could signal growing Republican determination to get out in front of the administration's public outreach program with a message that could reinforce already widespread public dislike for the law.
BATTLE OVER WOMEN
"Republicans are taking advantage of the timing of uncertainty and a lack of education about the health reform law before the administration has time to tell its positive, popular aspects," said Julie Barnes, a healthcare expert at the consulting group Breakaway Policy Strategies.
The biggest piece of social legislation since the creation of Medicare and Medicaid in the 1960s, the Affordable Care Act is expected to draw 7 million people next year to new state healthcare marketplaces, or exchanges, where low-to-moderate income families will be able to obtain private insurance at subsidized rates. Another 8 million people are expected to gain coverage through Medicaid.
Those figures compare with nearly 49 million Americans who lack health insurance.
Officials said the new $150 million outreach effort is being funded through an $11 billion community health center budget and will channel money to centers that operate 9,000 service delivery sites in all 50 states, serving approximately 21 million patients a year.
Open enrollment is set to begin on October 1, giving the administration barely five months to complete the Herculean task of establishing exchanges in 33 states that are unready or unwilling to create their own. Seventeen states and the District of Columbia plan to operate their own exchanges.
The Department of Health and Human Services has set aside about $1.26 billion for implementation this fiscal year, which ends September 30.
Because the law's main provisions are not set to begin until January 1, 2014, analysts say the administration faces a challenge overcoming public misunderstandings about the law to persuade enough young, healthy people to sign up for coverage to keep costs from soaring.
Healthy consumers are necessary to compensate for the added risks of insuring older or sick people, who use more healthcare services and are expected to sign up in large numbers.
On Friday, Obama will personally host a White House event to promote the law's benefits for women, who will get free coverage for preventive services such as mammograms.
McConnell, citing the event, delivered his own message about the healthcare law and women on Thursday.
"There are many ... small businesswomen who will see their dreams crushed under the weight of Obamacare's nearly 20,000 pages of regulations," he said on the floor of the Senate.