Government auditors said Thursday that 2 million fewer people will pay an Obamacare penalty for lacking insurance in 2016 than previously thought, marking yet another shift in the law's landscape as the government's top health agency welcomes a new leader.
A report by the Congressional Budget Office said the government will rake in $3 billion less in revenue due to changes in the economy and the Health and Human Services Department's decision to extend "hardship exemptions" to people who find it hard to get covered.
The estimates coincided with the Senate's confirmation of Sylvia Mathews Burwell to lead HHS in a vote that mixed bipartisan support for her capabilities with serious doubts about the rollout of Obamacare.
"I think she's done a pretty nice job of navigating that problem," said Carl Tobias, a professor at the University of Richmond School of Law who studies executive appointments. "At least going in, there are promising signs."
Mrs. Burwell cruised to the helm of the massive agency by a 78-17 vote. She will replace Kathleen Sebelius, whose tenure at HHS was marked by the rocky web rollout of the federal health exchange last year and frequent sparring with congressional Republicans.
By a 24-17 margin, more Republicans voted for Mrs. Burwell than against her, although some conservatives said the law's uneven implementation is cause for concern.
Revised estimates from the CBO and Joint Committee on Taxation found that 4 million people will pay a penalty in 2016 for flouting the law's so-called "individual mandate," which requires which requires Americans to obtain health insurance if they can afford it. Auditors initially thought 6 million would pay the tax penalty.
The penalty for lacking insurance is the higher of $95 or 1 percent of household income above the filing threshold in 2014, rising to $695 or 2.5 of adjusted gross income in 2016.
Sen. Orrin Hatch, Utah Republican, responded to the report by highlighting the tax as just one of Obamacare's flaws.
"Under the onerous individual mandate alone, millions of Americans are now expected to pay up to $44 billion more in penalties over the next decade for a mismanaged healthcare law that is barely functional," he said.
Mr. Hatch voted for Mrs. Burwell on Thursday, but he wants her to follow through on a pledge to recoup federal grant money from states that launched failed or faulty health exchanges.
"If she's confirmed, I hope with all my heart she will live up to this commitment, and I expect her to do so," he said on the floor Thursday.
Others took a harder line against the nominee.
Senate Minority Leader Mitch McConnell on Thursday said Mrs. Burwell's willingness to implement Obamacare "calls her policy judgment into question" and was enough for him to oppose her nomination.
Some of Obamacare's fiercest critics, including Sens. John Cornyn and Ted Cruz of Texas, also were among those voting "no."
Sen. Pat Roberts, Kansas Republican who caught flack from his GOP primary opponent for supporting Mrs. Sebelius in 2009, voted against the nomination.
All voting Democrats supported Mrs. Burwell, and a key White House ally hailed the results.
"As Secretary of the Department of Health and Human Services, Sylvia Mathews Burwell will be a strong leader in the ongoing effort to expand health coverage to millions of Americans," said Anne Filipic, president of Enroll America, a nonprofit that promote the law's coverage options.
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