After making the miscalculation of giving Republican ideas on health-care reform national media coverage, Barack Obama has informed Congressional leaders that his new ObamaCare proposal will contain some of the GOP policy demands made during last week’s summit. Which ideas will Obama include? Surprisingly, tort reform is among them … in a way:
In a letter to the Democratic and Republican leaders of Congress delivered to Capitol Hill Tuesday afternoon, President Obama signaled that his mind is open to several provisions raised by GOP lawmakers during last week’s bipartisan health care reform summit, including medical malpractice reform, combating fraud, and killing off the special deal for Florida seniors secured by Sen. Bill Nelson, D-Florida.
“No matter how we move forward,” the president wrote, “there are at least four policy priorities identified by Republican Members at the meeting that I am exploring.”
Among them, the president said the health care reform bill he posted at WhiteHouse.gov last week already included ways to combat “fraud, waste, and abuse” but he was intrigued by an idea raised by Sen. Tom Coburn, R-Okla., a practicing ob-gyn, that “we engaged medical professionals to conduct random undercover investigations of health care providers that receive reimbursements from Medicare, Medicaid, and other Federal programs” to ferret out other abuses of the system.
The president suggested that while he had already directed Health and Human Services Secretary Kathleen Sebelius to award $23 million in grants for state-level demonstration projects to resolve medical malpractice disputes, he would be “open to including an appropriation of $50 million in my proposal for additional grants.” The current directive is an “authorization,” not an “appropriation,” so there is no guarantee the grants will be funded. This would change that and more than double the amount in grants.
In other words, Obama has only agreed to spend money on research rather than taking concrete action on tort reform. This includes no commitment to do anything after the demonstration projects conclude. It ignores the CBO analysis of existing tort-reform proposals that would save $54 billion from the federal deficit over the next ten years, and $11o billion for the industry as a whole in the same period. It also ignores the fact that California has had precisely this kind of tort reform in place for years, and has seen the same kind of savings (which the CBO used as part of its analysis).
What other ideas will Obama include? Obama will strip out the Cornhusker Kickback and the Florida waiver on Medicare Advantage cuts, dubbed Gator-Ade — which were already going to be gone anyway. The idea by Coburn to deputize medical professionals to sniff out fraud certainly may have value, but it hardly requires a system-wide overhaul to implement it. These ideas hardly touch the heart of the reform question, which is why Obama feels comfortable including them.
That isn’t true, though, of the fourth idea:
The fourth priority would be to ensure language allowing high-deductible health plans in the proposed health insurance exchanges, which combined with Health Savings Accounts, many Republicans believe “are a good vehicle to encourage more cost-consciousness in consumers’ use of health care services,” the president said.
That’s a good idea, but it’s going to undermine the financial incentives of the insurance industry to back ObamaCare. They want to force younger clients into expensive comprehensive plans in order to fund the more expensive care for older members of the pool. High-deductible plans won’t generate the revenues required to help insurance companies meet new mandates in must-issue laws and in community pricing, the latter of which progressives continue to demand.
The new bill means that Congress has to start over from Square One. The Democrats may figure out a way to cast this as a bipartisan bill while doing so, but they won’t get it done quickly or cleanly. It will pre-empt the reconciliation effort, as both chambers of Congress will have to pass it on brand-new processes, which means the Senate filibuster comes back into play. This looks like yet another miscalculation, a gambit that will keep Congress tied up on ObamaCare well into the spring and perhaps the summer.