While health care reform is now law, that doesn't mean the battles have ended in the halls of Congress on the issue, as the Secretary of Health found out Wednesday before a U.S. House Appropriations subcommittee.
For Secretary Kathleen Sebelius, the hearing was about the budget request of the Health and Human Services Department.
But for Republicans, it was a chance to remind the Executive Branch that the Congress has to approve some money which will be needed to run the new health reform law and the machinery associated with it.
The headline was that Sebelius said the White House is not going to ask for any extra money in next year's budget to fund some of the many items in the health law.
"How will you cover the cost of these things that are not in the budget?" demanded Rep. Todd Tiahrt (R-KS) of his state's former Governor.
"It says in the law - 'such sums as are required'," said Tiahrt, noting that 36 different programs were authorized with an open-ended funding mechanism in the budget, and yet none of them would receive money in this year's budget plan.
"Your department right now does not have a request from the President for 'such sums as required' on these 36 programs," said Tiahrt.
"That's correct," answered Sebelius, who said that the decisions on what to fund would be left up to the Congress.
At the same hearing, Rep. Dennis Rehberg (R-MT) also zeroed in another area where more money might be needed, that for a short-term high-risk insurance pool for people who right now don't have health insurance.
"You're going to have to come back to this Appropriations Committee and ask for more money," Rehberg told Sebelius, as they interrupted each other several times during Q&A.
"You said it was going to cost $5 billion," said Rehberg, "and it's not."
"Well, we don't know what it's going to cost," Sebelius replied.
Answers like that only infuriated Republicans even more, convinced that the health care law is going to cost much more than the original estimates of recent months.
The back-and-forth though was a reminder that Congress still controls the purse strings under the Constitution, and that for the law to be implemented, money will have to be appropriated for those specific items.
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