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Lawmakers question PPACA Basic Health Program funding

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Two high-ranking Republicans in the House are wondering whether the U.S. Department of Health and Human Services (HHS) has any legal basis for paying for the Patient Protection and Affordable Care Act (PPACA) Basic Health Program (BHP).

A state can use a BHP to provide a state-run managed care plan for residents who earn a little too much to qualify for Medicaid. Minnesota set up a BHP in 2014, and New York state launched a BHP earlier this year.

See also: Weird PPACA plans

Rep. Fred Upton, R-Mich., chairman of the House Energy and Commerce Committee, and Rep. Kevin Brady, R-Texas, chairman of the House Ways and Means Committee, talk about the BHP funding question in a letter sent to HHS Secretary Sylvia Mathews Burwell earlier this week.

Upton and Brady write in the letter that their committees have been trying to get information about BHP funding since June 2015. In 2015, the lawmakers say, the committees asked HHS how the Obama administration has been supporting the BHP system without a congressional appropriation bill approving BHP spending.

In November, HHS provided 24 pages of documents, but it “unilaterally redacted the text on many of these pages,” Upton and Brady say.

In January, HHS let committee staff members see the unredacted documents in its own offices, and the staff members found that the redacted information was publicly available in other documents, the lawmakers say.

The House Energy and House Ways and Means committees each sent HHS subpoeans in March. HHS has responded by sending the committees “one heavily redacted page of one document,” the lawmakers say.

“Your refusal to provide the requested documents and information raises serious concerns about the department’s willingness to be accountable for the lawful execution of laws passed by Congress,” Upton and Brady say.

PPACA drafters created the PPACA public exchange system to help moderate-income families shop for health coverage. PPACA drafters added a premium subsidy program and a cost-sharing reduction system to help lower-income people pay for their exchange plan coverage.

PPACA drafters added the BHP provision to give states a chance to provide a better, cheaper alternative to PPACA exchange plans for moderately low-income residents. A state with a BHP can collect most of the federal money that otherwise would go to pay the eligible residents’ PPACA exchange plan subsidies. The state is supposed to use the money to offer eligible residents a choice of at least two high-quality managed care plans.

House Republicans’ also have questioned how the Obama administration has paid for the PPACA exchange cost-sharing reduction subsidy program in the absence of a congressional appropriation.

A U.S. district court judge in the District of Columbia ruled in May that HHS has no constitutional right to pay for the cost-sharing reduction subsidy program.

The Obama administration has argued that members of Congress have no standing to sue in federal courts to block Executive Branch spending.

See also:

Court ruling threatens $5 billion in PPACA insurer subsidy payments 

PPACA program appeals to Medicaid expansion fans


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