Joe Lieberman, Jay Rockefeller, and Sheldon Whitehouse's bid to save the Medicare Commission
Joe Lieberman's successful effort to tank the public option and Medicare buy-in does not mark the end of his involvement in health-care reform, But his next major initiative is actually good: He's partnered with Jay Rockefeller and Sheldon Whitehouse to save -- and even strengthen -- the Medicare Commission.
As attentive readers will remember, the Medicare Commission lost much of its bite when Reid merged the HELP and Finance bills. Among the biggest problems was that the commission now exempted hospitals for the first decade, contained a provision ending recommendations in 2019 if the rate of growth in Medicare spending fell behind that of private spending (which it often does), and lowered the savings the Commission was tasked with pursuing.
The Rockefeller-Lieberman-Whitehouse amendment repairs these flaws and, in fact, strengthens the Medicare Commission beyond the original proposal. Hospitals are no longer exempted and the language cutting off recommendations in 2019 is deleted entirely. The targeted savings are raised to 1.5 percentage points in 2015 and the schedule for Congress to consider the annual recommendations is moved up from August to June.
Then the proposal takes two big steps forward. First, the Commission is currently charged with submitting recommendations only in years when Medicare's growth rate exceeds the target. Now, it will have to submit a recommendation package in all years, "to clarify that the purpose of the Board is not simply to cut costs, but also to implement changes to the Medicare program that will strengthen and improve it for years to come." That's important: It ensures the Commission has a role in quality, rather than just cost. Though it's important to make Medicare cheaper, it's also important to make it better.
Second, the Medicare Commission is also empowered to offer recommendations that are applicable to the private sector, and the Secretary of Health and Human Services will have the power to apply these changes to plans operating within the health insurance exchanges. That gives the Medicare Commission a foot into the exchanges, which is sensible given that the taxpayer will be on the hook for subsidies within the exchanges.
Taken together, these recommendations would be a huge step forward for cost control in the bill. It's a shame that Lieberman mounted his most aggressive stand against the public option rather than in favor of this proposal, but even so, Rockefeller, Whitehouse, and Lieberman are all pushing in the right direction here. Whether other senators support this amendment will say a lot about how committed they actually are to controlling costs.
Photo credit: AP Photo/Harry Hamburg.