Backroom Deals — In Law and Rules
In his Wall Street Journal column this morning, Karl Rove writes about how Democrats have used the health care law to reward friends and punish enemies. Two examples mentioned in the column: The Administration’s frequent waivers granted to union plans from the new health insurance regulations, and all the exemptions provided in statute to the AARP’s lucrative Medigap business.
Politico also examines this issue from a slightly different angle, writing about the Administration’s decision to withdraw a portion of its Medicare physician payment regulation relating to end-of-life counseling. Its article quotes both White House press secretary Robert Gibbs (the full exchange from yesterday’s press briefing on the issue can be found here) and Rep. Earl Blumenauer as saying that only “process” concerns resulted in the withdrawal of the end-of-life provision.
There are several potential problems associated with this stance:
- If the problem with a proposed regulation is solely one of “process,” doesn’t that imply that the substance of the regulation has already been decided, and that allowing the public an opportunity to comment is merely a “tick-the-box” exercise?
- Why did the Administration go from attempting to defend the end-of-life provision in a Wall Street Journal article last week to withdrawing the provision entirely this week? What information about the regulatory process did White House officials learn in that time to prompt the U-turn – and when will that information be disclosed to the public?
- What about all the other backroom deals included in the health care law – or waiver actions alluded to in Mr. Rove’s column below? Will the American people be granted “an adequate space in a public comment period to debate these kinds of things” that Mr. Gibbs said would be provided on the end-of-life provision?
Finally, it’s worth pointing out that this morning’s Politico piece also quotes the president of Compassion and Choices – an organization formerly known as the Hemlock Society – as offering her support for end-of-life counseling. Prior to his controversial recess appointment as head of CMS, Dr. Donald Berwick was asked by a member of the Finance Committee whether he “had ever received funding from, been a member of, consulted with or for, or been associated in any way” with that organization. Has Dr. Berwick ever answered this question about any prior relationships with the former Hemlock Society – and does his silence explain why CMS acted the way it did regarding the end-of-life provisions?