Indeed, it's called the CMS Division of Quality, Evaluation, and Health Outcomes and it certainly wasn't created in the ACA. There seems to be confusion here between Congress instructing existing bodies to do something and "creating a new agency." One might even go so far as to say it's Congress's responsibility to define responsibilities for existing agencies.
Of course the law costs money. But if you think any significant chunk of that spending is on things like unpaid advisory boards or additional quality improvement responsibilities within CMS (instead of on, say, direct or indirect spending on health services), you've missed the boat somewhere along the way.
Let's take an example. Everything in these lists of "new agencies" with the words Medicare or Medicaid in it (and many things that don't, including anything related to the federal side of the ACA's insurance market reforms, exchange-related work, and various grant programs to states) falls under the purview of an existing agency in HHS, the Centers for Medicare & Medicaid Services (CMS). All of those value-based purchasing initiatives, those demonstration projects, the quality measurement initiatives, you name it. Here is what the funding for CMS looks like in Obama's FY2012 budget request (from HHS's FY2012 budget in brief):
Everything that seems to be bothering you so is in the green and purple slices--state grants and demos, new health insurance programs, the new Innovation Center (which is indeed one of the new bodies created in the law), and other administrative expenses. Together, it totals about 1.9% of CMS's outlays (<$15 billion).
The reason folks pass around inflated lists of alleged new bureaucracies is to give you a distorted conception of how much money is flowing to "bureaucracy."
This line of thought seems to be based more on faith than any sort of analytical argument. Making it easier for insurers to dump older or sicker folks through this kind of deregulation may make certain plans cheaper for certain people in certain pools (which isn't a particularly powerful argument in and of itself), but other factors at work within this strategy would be at work to push prices up. Meanwhile, regardless of where your insurer is headquartered, you still have to obtain care from local providers.
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