A top Democrat came out swinging Wednesday at HHS Secretary Kathleen Sebelius over questions he has about if the Affordable Care Act will be ready for implementation come October 1. During a Senate committee hearing, Sen. Max Baucus of Montana told her “the administration needs to do a better job” because he sees a 'train wreck' coming.

Baucus, chair of the Finance Committee and who helped write the ACA, drilled Sebelius on if federal exchanges will be ready and what the federal government is doing to make sure Americans understand how the law works. “The administration’s public information campaign on the benefits of the Affordable Care Act deserves a failing grade,” he said. “You need to fix this.”

The lack of clear information is leading to misconceptions and confusion. “People generally dislike what they don’t understand. I hear from the people on the ground in Montana that they are confused about the new health care law. People are worried about the impacts,” Baucus, a senator since 1978, said.

He reminded Sebelius they have discussed this many times and, yet, “I don’t see any results.” He then asked if HHS will set up benchmarks or surveys, “any data. I’d be happy to review data. You haven’t given me data, just concepts, frankly,” Baucus said.

The hearing turned heated as Baucus cut Sebelius off a few times while shouting questions as she answered them. “We do have a campaign and plans leading to open enrollment,” she said. “How many? What states?,” Baucus said, adding, “you can only do a decent job if you have the answers to these questions.” Sebelius responded that the request for proposal just went out and the information is not back in HHS hands yet.

 Also discussed at the hearing was the role of a broker in the exchanges and the definition of a navigator, which Sebelius defined as an individual who will go through training and be able to help educate people.

Questioned about the medical loss ratio and the potential loss of income for brokers and agents, Sebelius said that there is no prohibition for agents/brokers to be navigators.

Also, she added that state-run exchanges can designate an agent/broker to perform outreach within the funding models they develop. “We have not eliminated [a broker's] ability to do their jobs and bring people into insurance companies,” she said.

Baucus ended the nearly two-hour hearing with a cautious note. “Good luck,” he said to Sebelius.

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