Harkin: Forget defunding healthcare

Sen. Tom HarkinTom HarkinDistance education: Tumultuous today and yesterday Grassley challenger no stranger to defying odds Clinton ally stands between Sanders and chairmanship dream MORE (D-Iowa), the Senate's top health appropriator, warned Wednesday that Republicans can forget about defunding the healthcare reform law on his watch.

Harkin made the remarks during a Senate Appropriations Health subcommittee hearing on President Obama's fiscal 2012 budget proposal. Health and Human Services Secretary Kathleen SebeliusKathleen SebeliusFormer health chiefs: Stabilizing ObamaCare markets benefits Republicans OPINION | 5 big ideas to halt America's opioid epidemic Aligning clinical and community resources improves health MORE is the only witness testifying at the hearing.

"I'm well aware that some opponents of healthcare reform say they intend to use the Labor-HHS appropriations bill as a vehicle for defunding the Affordable Care Act," Harkin told Sebelius. "That will not happen."

Sen. Richard Shelby (R-Ala.), the top Republican on the subpanel, raised a number of concerns with healthcare reform spending. 

He pointed out that the proposed budget contains $4.2 billion in mandatory spending for the law — money that appropriators cannot reduce or rescind. Among the law's mandatory spending is $11 billion for community health centers over five years, which would normally be appropriated by Congress. The law also authorizes another $34 billion for the centers over five years, and that money is in the hands of appropriators.

"What happens if [healthcare reform] is repealed and agencies' baseline funding levels are too low to cover the cost of these programs?" Shelby asked.

The budget also includes $450 million in discretionary funding for healthcare reform. That money is in the hands of appropriators and is likely to spark spirited debate among the budget appropriators.

This includes $120 million for the long-term-care CLASS Act, $236 million for state health insurance exchanges, $38 million for the Healthcare.gov Web portal and $28 million to help consumers navigate the private insurance market.

"In times of economic uncertainty, when every department should be exercising fiscal restraint, I am disappointed the administration has not significantly reduced healthcare spending," Shelby said.