Senate Health Care Legislation Would Grant HHS Unprecedented Power Over States

In an earlier Health Affairs Blog post, we described several provisions in the Senate’s Better Care Reconciliation Act (BCRA) that would grant the U.S. Department of Health and Human Services (HHS) largely unchecked authority to make decisions that could significantly affect state budgets. We noted that, based on past interactions between state and federal Medicaid officials, HHS might use its resulting leverage to pressure states to fall in line with the current Administration’s policy preferences. Perhaps inevitably, exceptionally broad delegation of policymaking authority has become a defining feature of the Senate Majority Leader’s quest to restructure one-sixth of the American economy without hearings, expert testimony, committee consideration, or other safeguards of regular order. The President famously observed that health issues are “incredibly complicated.” Resolving such issues with careful attention to detail is too high a bar for most legislators to clear while moving at breakneck speed. For Republican leaders in Congress, the almost inescapable solution has been to structure legislation so that HHS will eventually answer policy questions that Congress currently lacks the time to resolve. Wholesale delegations of lawmaking power to Executive-branch agencies will almost certainly be larded throughout proposed legislation if the Senate approves this week’s expected “motion to proceed,” which would allow passage of a final bill after just 20 hours of ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Featured Following the ACA BCRA Source Type: blogs