The Health and Human Services Department “was given a billion dollars implementation money,” Republican Rep. Denny Rehberg of Montana said. “That money is gone already on additional bureaucrats and IT programs, computerization for the implementation.”

“Oh boy,” Stan Dorn of the Urban Institute said. “HHS has a huge amount of work to do and the states do, too. There will be new health insurance marketplaces in every state in the country, places you can go online, compare health plans.” …

“It’s a delegation of extensive authority from Congress to the Department of Health and Human Services and a lot of boards and commissions and bureaus throughout the bureaucracy,” Matt Spalding of the Heritage Foundation said. “We counted about 180 or so.” …

“They are asking for several hundred new employees,” Dorn said. “You have rules you need to write and you need lawyers, so there are lots of things you need to do when you are standing up a new enterprise.” …