WASHINGTON, April 28 Republicans in the U.S.
Congress are launching a fresh attack on the healthcare law by
targeting grants to states for creating insurance exchanges,
just as congressional budget analysts said on Thursday setting
up the marketplaces may be delayed.
Next week, the U.S. House of Representatives is expected to
take up a bill that would repeal funding for $1.9 billion in
grants for establishing exchanges where individuals can
purchase health insurance.
While the measure is expected to pass the
Republican-controlled House, this latest attack against
President Barack Obama's healthcare overhaul will likely go
nowhere in the Democratic-led Senate.
The exchange idea is a key component of Obama's healthcare
law, which has faced numerous challenges in Congress and the
courts since it was passed a year ago.
Exchanges must be operational by January 2014 and
self-supporting by January 2015.
But the Congressional Budget Office said in a new analysis
the exchanges are not expected to reach full enrollment until
"That expectation reflects the likelihood that some states
will encounter delays in achieving fully operational exchanges
in the first few years," CBO said. "In addition, participation
rates among potential enrollees are expected to be lower in the
first few years as employers and individuals adjust to the
More than half the states, along with business groups and
individuals, have sued, saying the law's requirement that
people buy insurance is unconstitutional and that the law
usurps states' sovereignty.
The Republican-controlled House voted to repeal the law
this year. But with Senate Democrats standing in the way of
full repeal, House Republicans are now working on bills to try
to undo the law bit by bit.
Two weeks ago, the House passed a bill that would yank
money for a prevention and public health fund. A bill repealing
grants for operating school-based health centers also could
come to the House floor as early as next week.
The CBO, which estimates the costs of legislation, said
blocking state grants for exchanges would reduce the U.S.
deficit by about $14 billion from 2012 through 2021.
Rescinding the funds, though, would not eliminate the
exchanges. Instead, it would shift much of the responsibility
for creating the marketplaces to the federal government, which
could in turn push up U.S. costs, CBO said, although it did not
estimate the size of those obligations.
States can create exchanges alone, band with neighboring
states, or opt out entirely and have the federal government
establish exchanges within their borders.
(Reporting by Lisa Lambert and Donna Smith; Editing by James