President Obama’s budget proposal seeks a major funding boost to bolster the IRS, which will enforce his health care law’s individual mandate, and to set up insurance exchanges.
The 2014 plan, submitted to Congress on Wednesday, requests $440 million to help the Internal Revenue Service get ready.
The agency must process tax credits for the exchanges and will assess tax penalties on those who fail to acquire insurance. Both of those provisions are slated to begin in 2014.
Mr. Obama also requested $1.5 billion through the Department of Health and Human Services to fund federally run health exchanges.
HHS Secretary Kathleen Sebelius said Congress must approve the funds needed to run the state-based markets, or exchanges, that allow consumers without employer-based insurance to shop for health plans with the help of tax credits.
More than half of the states have asked the federal government to run their exchanges instead of taking on the task themselves through grant funds, raising questions about the Obama administration’s ability to carry out the project.
“We certainly hope that Congress will come through with the funds,” said Ellen Murray, assistant HHS secretary for financial resources, told reporters before reaffirming plans to have the exchanges ready by Oct. 1. “We’re determined to make these work.”
Funding for the health law has proved controversial. Congressional Republicans have repeatedly sought to cancel funding for the entire law and for various parts of it. Canceling funding would have the same effect as repealing the law itself.
But Senate Democrats have defeated those proposals, and Mr. Obama had vowed to veto them anyway. That’s allowed the money to keep flowing.
Budget figures in Mr. Obama’s proposal show the government provided $4.4 billion in grant funds for fiscal years 2012 and 2013 to states that are establishing the exchanges on their own, a figure expected to reach $5.7 billion through fiscal 2014. The tally is more than twice the projected amount, according to a Bloomberg report.
This year’s budget also requests $235 million for an initiative to pinpoint mental health problems in youth and prevent gun violence in the wake of the Dec. 14 school shooting in Newtown, Conn., that killed 20 children and six adults. Specifically, it seeks $205 million to train officials at 8,000 schools and 5,000 mental health professionals to recognize early warning signs of behavioral health problems in young people and refer them to services, and dedicates $30 million toward research on homicides and suicides as part of efforts to prevent gun violence.
“While we know that the vast majority of Americans who struggle with mental illness are not violent, recent tragedies have reminded us of the staggering toll that untreated mental illness takes on our society,” Mrs. Sebelius said. “That’s why we’re proposing a major new investment to help ensure that students and young adults get the treatment they need.”
In addition to the new funding, Mr. Obama’s budget proposes some health cuts.
It seeks about $400 billion in health savings by tweaking drugs rebates under Medicare and asking high-income enrollees within the program to pay higher premiums, among other reforms more likely to impact the drugmakers and health providers than enrollees’ benefits.