A senior Democratic senator who helped write President Obama’s health care law stunned administration officials by saying openly he thinks it’s headed for a “train wreck.”

Sen. Max Baucus of Montana, chairman of the Senate Finance Committee, delivered his tough-love assessment of efforts to implement the Affordable Care Act during a budget hearing that featured Health and Human Services Secretary Kathleen Sebelius.

From the outset, the senator’s terse and pointed questions made it clear that he did not think her agency had done enough to implement key pillars of the law by 2014.

He also said he is “very concerned” by the lack of information among small business and accountants who are “throwing their hands” up over the law.

“I just see a huge train wreck coming down,” Mr. Baucus said Wednesday. “You and I have discussed this many times, and I don’t see any results yet.”

His comments turned heads because Republicans are typically the ones who openly criticize Mr. Obama’s signature domestic achievement.

Mr. Baucus has served in the Senate since 1978 but faces a tenuous battle for re-election in 2014.

Last month, he was among four Democrats from traditionally red states who voted against the Senate Democrats’ budget plan for the coming year. And Wednesday, he was among a handful of Democrats who did not support a bill that would expand background checks before certain gun sales signs of just how fragile his political terrain has become.

For her part, Mrs. Sebelius told Mr. Baucus she was “incredibly disappointed” that her requests for more outreach-related resources in a short-term funding plan for 2013 were denied.

“I don’t know what he’s looking at,” Mrs. Sebelius said of Mr. Baucus after the hearing, according to The Associated Press. “But we are on track to fully implement marketplaces in Jan. 2014, and to be open for open enrollment.”

Starting next year, Americans without employer-based health insurance will be able to shop for coverage on state-based marketplaces, or “exchanges,” through the help of tax credits. About half the states, however, have asked the federal government to set up an exchange for them instead of taking on the task.

Mr. Obama requested $1.5 billion in his fiscal 2014 proposal to help the agency set up exchanges run by the federal government, although it is unclear if Congress will provide it.

Also in 2014, enrollment in the Medicaid program for the poor will be extended to those earning up 138 percent of the federal poverty level in states that opt into the expansion.

Republican opponents who are attempting to chip away at the president’s law seized on Mr. Baucus‘ comments Wednesday. Rep. Scott R. Tipton, Colorado Republican, invoked the Montanan’s words during a hearing on the health care law before the House Committee on Small Business.

“The uncertainty is enormous about what will and will not get done,” Douglas Holtz-Eakin, a former director of the Congressional Budget Office, told Mr. Tipton. “I think Sen. Baucus‘ comments reflect the uncertainty about whether the exchanges will be up and running on time.”

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