World and Nation

Democratic senators voice health care law concerns

WASHINGTON — Democratic senators, at a caucus meeting with White House officials, expressed concerns Thursday about how the Obama administration was carrying out the health care law they adopted three years ago.

Democrats in both houses of Congress said some members of their party were getting nervous that they could pay a political price if the rollout of the law was messy or if premiums went up significantly.

President Barack Obama’s new chief of staff, Denis R. McDonough, fielded questions on the issue for more than an hour at a lunch with Democratic senators. Sen. Jeanne Shaheen, D-N.H., who is up for election next year, said, “We are hearing from a lot of small businesses in New Hampshire that do not know how to comply with the law.”

In addition, Shaheen said, “restaurants that employ people for about 30 hours a week are trying to figure out whether it would be in their interest to reduce the hours” worked by those employees, so the restaurants could avoid the law’s requirement to offer health coverage to full-time employees.

The White House officials “acknowledged that these are real concerns, and that we’ve got to do more to address them,” Shaheen said.

Sen. Tom Harkin, D-Iowa, chairman of the Appropriations subcommittee on health care, said he was extremely upset with Obama’s decision to take money from public health prevention programs and use it to publicize the new law, which creates insurance marketplaces in every state. “I am greatly disappointed — beyond upset — that the administration chose to help pay for the Affordable Care Act in fiscal year 2013 by raiding the Public Health and Prevention Fund,” Harkin said.

The administration said it had transferred $332 million from the prevention fund to pay for “education and outreach” activities publicizing the new insurance markets, or exchanges.

To express his displeasure, Harkin has blocked Senate action on Obama’s nominee to be administrator of the Centers for Medicare and Medicaid Services, Marilyn B. Tavenner. By putting a “hold” on the nomination, aides said, Harkin hopes to draw the White House into negotiations on the future of the prevention fund, which he has championed.

At congressional hearings this week, Kathleen Sebelius, the secretary of health and human services, said it was necessary to tap the prevention fund because Congress had refused to provide money requested by the president for outreach and education activities.