The Devil is in the Details of the Healthcare Bills, Or Not | Citizens Against Government Waste

The Devil is in the Details of the Healthcare Bills, Or Not

The WasteWatcher

President Obama and congressional Democrats have been playing defense on healthcare reform throughout the month of August as congressional town hall meetings across the country have erupted in anger and frustration.  A favorite theme in the President’s and his allies’ speeches is that Americans have been manipulated and exploited by opponents of his healthcare initiatives, jack-booted obstructionists who are peddling falsehoods about what is actually in the bills. 

Simultaneously, and somewhat incoherently, members of Congress who support the inclusion of a government-run option in healthcare reform legislation (as well as some of the other controversial items) have also been trying to peddle the line that taxpayers are overreacting, that there really is “no bill yet.”  Sen. Arlen Specter (D-Pa.) arrogantly dismissed opposition to the bill, telling “FOX News Sunday” host Chris Wallace on August 23, 2009 that, “There's no bill in the Senate.  There's no bill on the House floor.  A couple of House committees have considered it.”

Not yet, anyway.  Nevertheless, that kind of desperate spin rankles taxpayers who have actually leafed through the impenetrable, 1,000-page “draft” document that passed out of the House Energy and Commerce Committee (H.R. 3200) along party lines prior to the August recess.  In fact, at town hall meetings, furious constituents are taking to the microphones armed with specific section numbers, quoting sections verbatim from both H.R. 3200 and the Senate’s Affordable Health Choices Act (commonly known as the Kennedy-Dodd bill), and asking very tough questions.  Contrary to Sen. Specter’s technically-correct but rather delirious assertion, there are concrete proposals being debated and voted on.  Taxpayers understand that and they do not like what they see. 

Almost as important as what is contained in the various versions of healthcare reform currently under consideration in the House and Senate is what is not included.  In the House, H.R. 3200 was parceled out to multiple committees for markup; amendments were crafted, debated, accepted, or rejected.  It is instructive to review which amendments committee members chose to include and which they rejected. 

During the House Energy and Commerce Committee markup, Rep. Cliff Stearns (R-Fla.) offered an amendment that would have codified that nothing in the final bill would prevent people from keeping their current healthcare plans, a principle President Obama has repeatedly committed himself to.  Several committee members simply did not believe that such a guarantee was warranted so they voted the Stearns amendment down. 

Reps. Mike Rogers (R-Mich.), Jim Matheson (D-Utah), and Phil Gingrey (R-Ga.) offered an amendment that would have ensured that health insurance plans which currently include the option of a Health Savings Account (HSA) would fit the statutory definition of a “qualified health benefits plan.”  HSAs feature low premiums, have high deductibles and are owned and controlled by patients.  The committee defeated that amendment. 

Much has been made of the inclusion of a provision establishing a Comparative Effectiveness Research (CER) tool, a new bureaucracy within the Centers for Medicare and Medicaid Services (CMS) that would track which medical procedures are most effective at treating specific cases, collecting information on both their cost and clinical results.  The idea of collecting and making public data on healthcare outcomes is an excellent one, but not if it will one day be used by federal bureaucrats as a tool to force doctors into making specific treatment decisions, determine health insurance coverage, or deny care to patients.  Reps. Rogers and Gingrey (who is a physician), offered amendments that would have barred CMS from using the research gathered by CER to make coverage decisions on the basis of cost or to ration care.  The good news is that those amendments passed (by voice vote).  The bad news is that similar amendments under consideration in the House Ways and Means and Education and Labor Committees were defeated, which leaves the Speaker of the House and the House Rules Committee as the final arbiters to resolve that conflict. 

During 13 days of debate over the Kennedy-Dodd bill, which was voted out of the Senate Health, Education, Labor and Pension Committee on July 27, 2009, hundreds of amendments were offered.  Sen. Tom Coburn (R-Okla.), also a physician, offered many, one of which would have required all members of Congress and their staffs to enroll in the government-run health insurance option, the most contentious provision under consideration among the current reform proposals.  Today, members of Congress, their staffs, and all federal employees and their families, 6.6 million people, are covered under the highly successful Federal Employees Health Benefits Plan, in which 283 private health insurers from around the country compete for their healthcare dollars, offering a wide range of options from which to choose.  The Coburn amendment passed by one vote, but it will be anyone’s guess if that provision survives final passage of any healthcare reform bill. 

Taxpayers’ visceral expressions of opposition to these so-called reforms over the August recess have put Congress on notice that the plans under consideration in Washington will not fly.  However, when Congress reconvenes this fall, taxpayers must not assume the job is done and Congress will go back to the drawing board.  They will need to continue to exercise sharp vigilance over the process if they intend to force the Democratic leadership and the Obama administration to fully abandon the ill-conceived government-run health insurance option, as well as the multitude of other toxic provisions being bandied about in the nation’s capital.  It won’t be enough to simply watch what lawmakers do; it will be just as crucial to watch what they don’t do. 

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