It’s going to take a long time to unwind all the damage of the Obama era. Once ascendant in Washington, liberals left all sorts of traps behind to perpetuate their ideological vision even long after they had been voted out of office.
Among the obvious examples: the Consumer Financial Protection Bureau, intentionally funded outside of the congressional appropriations process with the hopes of leaving it utterly unaccountable, Obamacare’s “IPAB” rationing board, which the law actually attempts to prevent Congress from repealing, and, of course, Obama’s many left-wing judicial appointees, who will no doubt be locating emanating penumbras heretofore hidden in the law for decades to come.
Thankfully, a Trump presidency is beginning to bring an end to the madness. But there are still many Obama remnants left to dismantle.
One of the less visible of these is what Obamacare dubbed the “Center for Medicare and Medicaid Innovation” (CMMI), which is designed to give entrenched liberal bureaucrats a means of rewriting health care law without congressional approval.
This unconstitutional power is cloaked in the guise of pilot studies to find cost-savings. CMMI conducts a “study” and, upon announcing its belief that it was a success, immediately declares whatever “innovation” it had been evaluating the new law of the land.
One of the office’s first such “studies” altered health care for 75% of Medicare patients and attracted vehement opposition from every senator, Republican and Democrat, on the Senate Finance Committee (which, given Democrats’ mindless devotion to defending Obamacare, is nothing short of remarkable).
The kicker is, in one of its more ludicrous interpretations, the Congressional Budget Office has deemed that any congressional intervention of the program “costs” money from potential reforms the office has yet to invent, let alone implement. Thus any bill to reform this dangerous program must be “offset” with other spending cuts under budget rules.
The good news is that Tom Price, the Secretary of Health and Human Services (HHS), is in great position to reign in this program before it does any more damage.
Price should move quickly to issue clear (and narrow) limits to the scope of CMMI’s innovative power grabs. In the short term, this will limit the harm the office can cause. In the long term, this can make it easier for Congress to reform the law, as the limits will constrain CBO’s fervent imagination about what types of cost savings can be surreptitiously thrust on the American people.
Experts who have analyzed how CMMI is constructed say there’s several ways that such a rule could effectively constrain it’s “mission.”
First, the scope of a CMMI “test” should be defined to prevent wholesale policy changes like those implemented by the Obama administration. If a pilot study impacts the care received by most people on Medicare, or even most people of some subset of patients, it’s not a pilot study. A test should impact a small group so its results can be scrutinized. Only successful tests should be replicated on larger numbers.
Second, the tests should be conducted (as pilot studies normally are in the medical profession) on volunteers. It’s not fair, and arguably illegal, to give some people worse health care because they are guinea pigs in a government study dreamed up by Washington bureaucrats.
Third, the government needs to seek public input on which tests it is conducting and how it designs them. One of the most fundamental parts of due process is the opportunity to provide input when the government is considering changes that could negatively impact major economic sectors. It’s also common sense: the government, to the dismay of Bernie Sanders, does not possess all of the knowledge and wisdom in this land. The practice of keeping these studies secretive is one of its most pernicious aspects.
Price could begin work on rules like these tomorrow. They will do much to limit the damage until Congress can put an end to law-by-bureaucrat for good.
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