More Dollars for Health Care

It's called the Affordable Health Care Act, now a public law.  I have read much of the 900+pages and I am amazed at the amount of money consumed by this law that claims to be such a landmark for "affordable" health care.

Below is the summary table from the current budget proposal for HHS

FY 2014 President’s Budget for HHS

 (dollars in millions)

	2012	2013	2014
Budget Authority	873,872	909,524	974,594
Total Outlays	848,153	907,797	967,295
Full-time Equivalents (FTE)	74,193	76,209	77,520

To compare those figures, here is similar data from the last three budgets of the Bush Administration.[ FY2009 budget proposal for HHS, was the last proposal by the Bush administration in 2008.]

FY 2009 President’s Budget for HHS

(dollars in millions)

	2007	2008	2009
Budget Authority	656,726	715,790	731,407
Outlays	670,413	707,723	736,793
Full-Time Equivalents	63,748	64,750	65,630

[FTE can most easily be described as the number of full time employees.]

Growth during the Obama administration

Personnel – 11,890

Dollars - $243,187,000,000.00

That's a two hundred forty-three billion, one hundred eighty-seven million dollar increase in the five years since President Obama took office, and nearly a 50% increase from the 2007 budget.

Budgets are all about money, usually money being spent.  The HHS budget proposal for FY2014 makes over 100 references to "affordable care."

Here are some excerpts.

 The Budget includes $389 million in discretionary and mandatory funding for the Office of Inspector General (OIG), an increase of $101 million above the FY 2012 level. This increase will enable OIG to expand CMS Program Integrity efforts for the Health Care Fraud Prevention and Enforcement Action Team and improper payments, and also enhance investigative efforts focused on civil fraud, oversight of grants, and the operation of Affordable Care Act programs.  

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  Health centers are an essential primary care provider for America’s most vulnerable populations and are a critical component of the healthcare system as more individuals gain insurance coverage and access health care services through the Affordable Care Act. The Budget includes $3.8 billion for the Health Center program, including $2.2 billion in mandatory funding provided through the Affordable Care Act Community Health Center Fund. In FY 2014, the Health Center Program will support more than 1,200 grantees, and serve approximately 23 million patients. 

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  IHS estimates that the Affordable Care Act will increase health insurance reimbursements by $95 million in FY 2014. These resources will allow IHS to address the needs of its ever-expanding population and provide additional health care, further reducing health disparities in the American Indian and Alaska Native population. However, estimating the amount of  the increase IHS will collect in FY 2014 is complicated  both by a lack of information about which states will  choose to expand Medicaid and uncertainty about the  number of American Indians and Alaska Natives who  will become eligible because of expansion and will  continue to use IHS services.   

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Additionally, the FY 2014 Budget includes $10 million to enable public health agencies to seek reimbursement from insurance companies for infectious disease testing covered because of the implementation of the Affordable Care Act. 

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The Budget  includes a total of $100 million for Patient-Centered  Health Research (also known as Patient-Centered  Outcomes Research or Comparative Effectiveness  Research), provided through the Patient-Centered  Outcomes Research Trust Fund (PCORTF). The PCORTF, established by the Affordable Care Act, transfers funding to HHS to build research capacity, translate and disseminate comparative clinical effectiveness research, and establish grants to train researchers. In FY 2014, investments will build on current AHRQ efforts, such as programs to train researchers in methods and standards for conducting patient-centered outcomes research and dissemination and translation efforts.  

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The Affordable Care Act includes an additional $350 million in program integrity resources over 10 years, plus an inflation adjustment. It provides unprecedented tools to CMS and law enforcement to protect Medicare, Medicaid, and CHIP from fraud, waste, and abuse. 

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