I’ve started reading the health care bill (H.R.3200), and one thing that has caught my attention already is the position of “Health Choices Commissioner,” referred to throughout the bill as simply “Commissioner.” The Commissioner would be appointed by the President to head up a newly-created, “independent agency in the executive branch of the Government” called the Health Choices Administration.
The Commissioner would have broad, sweeping powers. “Commissioner” appears 203 times in the bill, so I can’t list everything, but here are just a few of the Commissioner’s powers:
- Establish qualified health benefits plan standards, including the enforcement of those standards.
- Establish and operate a “Health Insurance Exchange” in which private health care plans will have to participate.
- Define the terms “employer,” “employee,” “full-time employee,” “part-time employee,” and “dependent” for the purposes of the bill.
- Access financial records of private health insurers and companies who self-insure and report it to Congress. “Such report shall include any recommendations the Commissioner deems appropriate to ensure that the law does not provide incentives for small and mid-size employers to self-insure.”
There are many more things the Commissioner gets to decide. In fact, a lot of the language in the bill is vague, and the Commissioner is given the power to define the specifics. If you thought the Department of Homeland Security had too much power (and gave the Executive Branch more power than the other branches), just wait until this takes effect. It will take — what is it, something like 13% of the U.S. economy? — and put it under the direct control of the Executive Branch. And this one person, whom the President will appoint, will have nearly unfettered authority to define terms, and establish and enforce standards.
You can get all the details here, but here’s a summary of President Obama’s less-than-accurate points during his health-care speech Wednesday night:
- Obama was correct when he said his plan wouldn’t insure illegal immigrants; the House bill expressly forbids giving subsidies to those who are in the country illegally. Conservative critics complain that the bill lacks an enforcement mechanism, but that hardly makes the president a liar.
- The president said “no federal dollars will be used to fund abortions.” But the House bill would permit a “public option” to cover all abortions, and would also permit federal subsidies to be used to purchase private insurance that covers all abortions, a point that raises objections from anti-abortion groups. That’s true despite a technical ban on use of taxpayer dollars to pay for abortion coverage.
- The president repeated his promise that his plan won’t add “one dime” to the federal deficit. But legislation offered so far would add hundreds of billions of dollars to the deficit over the next decade, according to the Congressional Budget Office.
- The president overstated the degree of concentration in the insurance industry. He said that in 34 states the “insurance market” is controlled by five or fewer companies, but that’s true only of insurance bought by small groups, not the entire “insurance market.”
- Obama said his plan won’t “require you or your employer to change the coverage or the doctor you have.” It’s true that there’s no requirement, but experts say the legislation could induce employers to switch coverage for millions of workers.
Regarding that third point: I have watched and read even the most liberal columnists say that the President’s promise to provide national health care without raising the deficit is totally bogus. It is going to raise the deficit. A lot.
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