Lame ducks should avoid health policy
A lame-duck Congress typically is driven by a desire to “get things done.” But lawmakers should resist ramming last-minute deals on Medicare physician payments and the Children’s Health Insurance Program through this Congress.
While end-of-year sessions are often needed to clean up routine budget and appropriations bills, past lame-duck sessions have resulted in members of Congress voting themselves special pay or retirement raises or handing out billions of dollars to favored special interests. Untethered from accountability to their constituents, soon-to-be-unemployed politicians can repudiate popular opinion with impunity, while bypassing the deliberation that the Founders expected of the legislature in a constitutional republic.
A lame-duck session this year would pose two big threats on the health care front.
Medicare doctors are facing a 21 percent pay cut effective March 15 because of scheduled — and wholly unrealistic — “updates” to the Sustainable Growth Rate payment formula. Virtually all lawmakers agree that Medicare’s flawed payment system should be replaced. But that undertaking must be done right. Any lame-duck efforts to enact a permanent fix without offsetting the extra costs via permanent savings elsewhere in the budget should be stopped cold.
The so-called “compromise bill” that House and Senate negotiators agreed to last spring does not meet that test. For one thing, it did nothing to reduce the bureaucratic overregulation that drives Medicare physicians crazy and ramps up costs. Worse, there was no congressional agreement on how to offset the huge cost that “fix” would impose on taxpayers.
Indeed, the Congressional Budget Office estimated that its initial 10-year cost was $138 billion, and the unfunded “fix” would continue to add massively to the nation’s deficit thereafter. Taxpayers should not be burdened with heavier debt because an irresponsible Congress wants to bum-rush Medicare physician payment reform.
The second threat arises from the Children’s Health Insurance Program. CHIP was created to provide coverage for uninsured children whose families earned too much to qualify for Medicaid. Its continued role, however, is uncertain due to the enactment of the Affordable Care Act. Yet, some are calling for Congress to provide additional funding for the CHIP program in the lame-duck session. It shouldn’t.
Congress must do its due diligence before promising additional taxpayer dollars for CHIP. This requires hearings to review the program’s effectiveness, as well as determining how much funding is still available in the program and how the remaining funding is distributed among the states.
Other important issues relating to enrollment and the interaction of the CHIP program with the Affordable Care Act also need to be addressed. These questions should be raised through the normal congressional process of hearings and committee mark-ups. Fast-tracking the bill would be tantamount to asking taxpayers to write a check without offering any justification for the request.
Members of Congress (even those who are soon to depart) should assure accountability and protect America’s taxpayers by sparing the country a lame-duck session and letting the new Congress do its job.
Nina Owcharenko is director of the Center for Health Policy Studies at The Heritage Foundation (heritage.org), where Robert E. Moffit is a senior fellow.