A senior Democratic senator who helped write President Obama's health care law stunned administration officials Wednesday, saying openly he thinks it's headed for a "train wreck."
"I just see a huge train wreck coming down," Senate Finance Committee Chairman Max Baucus, D-Mont., told Obama's health care chief during a routine budget hearing that suddenly turned tense.
Baucus is the first top Democrat to publicly voice fears about the rollout of the new health care law, designed to bring coverage to some 30 million uninsured Americans through a mix of government programs and tax credits for private insurance that start next year.
The six-term Democrat is also expected to face a tough re-election in 2014. Baucus is still trying to recover from approval ratings that nosedived amid displeasure with the health care law in his home state.
Normally low-key and supportive, Baucus challenged Health and Human Services Secretary Kathleen Sebelius at Wednesday's hearing.
He said he's "very concerned" that new health insurance marketplaces for consumers and small businesses will not open on time in every state, and that if they do, they might just flop because residents don't have the information they need to make choices.
"The administration's public information campaign on the benefits of the Affordable Care Act deserves a failing grade," he told Sebelius. "You need to fix this."
Responding to Baucus, Sebelius pointedly noted that Republicans in Congress last year blocked funding for carrying out the health care law, and she had to resort to raiding other departmental funds that were legally available to her.
The administration is asking for $1.5 billion in next year's budget, and Republicans don't seem willing to grant that either.
"I don't know what he's looking at," Sebelius told reporters following her out of the room after Baucus adjourned the hearing. "But we are on track to fully implement marketplaces in Jan. 2014, and to be open for open enrollment."
That open-enrollment launch is only months away, Oct. 1. It's when millions of middle-class consumers who don't get coverage through their jobs will be able to start shopping for a private plan in the new marketplaces, or exchanges. They'll also be able to find out if they qualify for tax credits that will lower their premiums. At the same time, low-income people will be steered to government programs, mainly an expanded version of Medicaid.
But half the states, most of them Republican-led, have refused to cooperate in setting up the infrastructure of Obama's law. Others, like Montana, are politically divided. The overhaul law provided that the federal government would step in and run the new markets if a state failed to do so. Envisioned as a fallback, federal control now looks like it will be the norm in about half the country, straining the resources of the department Sebelius leads.