Senate Republicans on Wednesday told President Obama's pick to lead the Health and Human Services Department that they expect the government to recoup millions of dollars in federal grants from states that set up flawed websites under Obamacare.
Sen. Orrin G. Hatch, Utah Republican, put Sylvia Mathews Burwell on notice during her confirmation hearing before the powerful Senate Finance Committee, saying roughly half of the states that opted to set up their own health care exchanges failed to build successful websites and should pay back the money they received from Washington over the next 10 years.
"One of the greatest challenges facing HHS is shoring up the federal and state-based health insurance exchanges," Mr. Hatch said. "Ensuring that the exchanges are operating efficiently and effectively will be one of your biggest challenges."
Mr. Hatch and Sen. John Barrasso, Wyoming Republican, filed a bill Wednesday requiring states that abandon their faulty Obamacare portals to make the federal government whole again.
Ms. Burwell said she would take stock of the problems in those states and draw back funds from the contractors or other entities at fault.
"Where the federal government and the taxpayer had funds misused, we need to use the full extent of the law to get those funds back for the taxpayer," she said.
Despite their distaste for Obamacare, Republicans said they admired Ms. Burwell's tenure as White House budget chief.
"She's competent," Sen. Tom Coburn, Oklahoma Republican, said at the start of glowing testimony to the committee.
Republicans sparred frequently with departing HHS Secretary Kathleen Sebelius, who announced in April that she would step down after the flawed rollout of the federal exchange system, HealthCare.gov. But that acrimony did not surface in the senators' questions for Ms. Burwell, quashing speculation that her nomination could morph into a proxy war over Obamacare.
Instead, Mr. Obama's Republican rivals pressed Ms. Burwell during her second confirmation hearing on cuts to Medicare Advantage — an insurer-run alternative to the traditional health care program for seniors — and narrow aspects of the overhaul to the national health care system.
Mr. Hatch, the committee's top Republican, used much of his time to tout his legislation, the State Exchange Accountability Act.
He and Mr. Barrasso have singled out seven states — Hawaii, Maryland, Massachusetts, Minnesota, Nevada, Oregon and Vermont — and the District of Columbia as falling short in their efforts, despite receiving a total of $1.4 billion to establish health care exchanges.
Three dozen states relied on the federal government to run their health care exchanges. The rest of the states experienced mixed levels of success in open enrollment from Oct. 1 to March 31. Kentucky, Connecticut, California and other states were able to roll out their exchanges relatively smoothly.
Some rollouts were full-scale disasters, prompting state officials to cuts ties with their contractors or rewrite their deals.
The bill's sponsors note that two of the worst-performing states, Oregon and Massachusetts, may request more federal funding to drop their exchanges and switch to the federal system.
Beyond the exchanges, Mr. Hatch asked Ms. Burwell to be responsive to lawmakers who are monitoring Obamacare, the fiscal health of Medicare and other aspects of the massive HHS budget.
"I wish you the best of luck as you work to address these challenges and as you continue going through the confirmation process," Mr. Hatch said. "You will need it."
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