CATO INSTITUTE: ‘Nuclear Option’ Does Enable Democrats To Ensure One-Party Authoritarian Control of Health Care

By Michael F. Cannon

This article appeared on Forbes.com on November 25, 2013.

Last week, I explained that the U.S. Senate’s deployment of the “nuclear option” — lowering the threshold for approval of non-Supreme Court presidential nominees from 60 votes to 51 votes — does not make it easier for President Obama to use ObamaCare’s Independent Payment Advisory Board. I need to add this caveat: during his tenure. The nuclear option does enhance the ability of the president and his party to control the health care sector well after he leaves office.

It’s true that the rules change will make it easier for the president to have his IPAB nominees approved by the Senate, particularly through January 2015, when the Democratic caucus holds 55 seats. But if the president and Senate fail to seat anyone on the IPAB, the board’s sweeping legislative powers fall to the Secretary of Health and Human Services. If President Obama wants to use IPAB’s powers during his term, therefore, he need only retain Kathleen Sebelius as his HHS secretary.

ObamaCare permits IPAB to exercise its powers, however, only if Medicare’s actuaries project the program’s outlays will grow faster than a specified rate. A number of readers note that Medicare’s actuaries reported earlier this year that their projections currently do not show Medicare spending exceeding that target rate, and that their projections likely will not do so during the remainder of President Obama’s term. Those projections and the resulting determination could change next year. If so, and if the president and Senate have not placed confirmed any IPAB members, Secretary Sebelius could use IPAB’s powers during President Obama’s term. Those powers include the ability to raise taxes, to ration care to Medicare enrollees, and to appropriate funds to her own department, without the consent of the people’s elected representatives. (Critics will object that IPAB has none of these powers. In this study, Diane Cohen and I explain why we think they are incorrect.) Sebelius’ “proposal” would take effect during 2016.

PLEASE READ MORE:  http://www.cato.org/publications/commentary/nuclear-option-does-enable-democrats-ensure-one-party-authoritarian-control?utm_source=Cato+Institute+Emails&utm_campaign=5e45bb1a43-Cato_Today&utm_medium=email&utm_term=0_395878584c-5e45bb1a43-141723190&mc_cid=5e45bb1a43&mc_eid=2653a08a51

Roll-call votes in Congress, March 25, 2012

Here's how local members of Congress voted on major issues in the week that ended Friday:

House

Medicare cost controls: Voting 223 for and 181 against, the House on Thursday sent the Senate a bill (HR 5) to repeal the Independent Payment Advisory Board established by the 2010 health law to use expert advice from outside government to slow the growth of Medicare costs. Starting in 2015, this panel will have power to restrain any annual Medicare spending increases that exceed official per-capita projections tied to such factors as inflation and the gross domestic product. Congress cannot reduce the sum of the panel's proposed cuts but can change individual parts after clearing high parliamentary hurdles. President Barack Obama has not yet named any of the 15 panel members, who will serve full time and need Senate confirmation for their six-year terms. House and Senate leaders of both parties will recommend 12 of the 15 nominees; Obama will unilaterally select the others.

The bill limits medical-malpractice awards (which should be a states issue), in part, by capping punitive damages at $250,000; shortening statutes of limitation for filing suits; making it easier for judges to cap attorneys' contingency fees; and requiring plaintiffs seeking punitive damages to prove the defendant acted with "malicious intent" and deliberate negligence in causing the injury. 

A yes vote was to pass the bill.  Voting yes: Renee Ellmers, R-2nd, Walter Jones, R-3rd, Virginia Foxx, R-5th, Howard Coble, R-6th, Larry Kissell, D-8th, Sue Myrick, R-9th, Patrick McHenry, R-10th.

Voting no: G.K. Butterfield, D-1st, David Price, D-4th, Heath Shuler, D-11th, Mel Watt, D-12th, Brad Miller, D-13th.
Not voting: Mike McIntyre, D-7th.

Dispute over Medicare: Voting 180 for and 229 against, the House on Thursday defeated a bid by Democrats to prevent the Republicans' bill on Medicare cost controls (HR 5, above) from contributing to any these outcomes: rationing health care; adding a voucher system that would partially privatize Medicare; ending guaranteed Medicare benefits for seniors or younger people who are disabled; or raising Medicare premiums, deductibles, coinsurance or copayments. 

A yes vote backed the Democratic motion. 
Voting yes: Butterfield, Jones, Price, Kissell, Watt, Miller.
Voting no: Ellmers, Foxx, Coble, Myrick, McHenry, Shuler.
Not voting: McIntyre.

Senate

Relaxing rules, raising capital: Voting 73 for and 26 against, the Senate on Thursday passed a bill (HR 3606) to relax major financial-reform laws of the past 10 years to help small and mid-size businesses rapidly enter capital markets, attract investors and create jobs. The bill defines a new category of firms with annual revenues under $1 billion that could float IPOs without first having to meet SEC requirements in such areas as auditing and transparency. For these companies, the bill would waive several investor-protection and corporate-governance rules set by the 2002 Sarbanes-Oxley and 2010 Dodd-Frank financial-regulation laws.

This bill lowers standards for providing investors with audited financial statements; eases reporting requirements on executive compensation; lets companies "crowd-fund" by using social media and the Internet to solicit large pools of small investors; increases the amount of capital a company can raise and the number of shareholders it can have without registering with the SEC; and raises from 500 to 2,000 the maximum number of shareholders in community banks.

Additionally, the bill reauthorizes the Export-Import Bank through mid-2016 while gradually increasing its lending authority to $140 billion. It extends a Small Business Administration program that provides companies with long-term financing for purchasing real estate and other fixed assets. 
A yes vote was to pass the bill.
Voting yes: Kay Hagan, D, Richard Burr, R.

Internet stock touts: Voting 64 for and 35 against, the Senate on Thursday added requirements to HR 3606 (above) for stricter auditing and transparency on the part of start-up companies seeking to raise capital from large pools of small investors over the Internet — a practice known as crowd-funding. For example, the amendment requires an officer of the company to stand behind the touts of the public offering, places caps on the amount individuals can invest as a proportion of their incomes, and sets up third-party intermediate portals as buffer zones between the company and solicited investors.

A yes vote was to adopt the amendment.
Voting yes: Hagan, Voting no: Burr

Key votes ahead

In the week starting Monday, the House will take up a temporary extension of surface-transportation programs, a proposed Republican budget for fiscal 2013 and later years and several competing budget plans. The Senate will consider bills to improve the U.S. Postal Service and repeal taxpayer subsidies for oil companies. Congress will begin a two-week recess at week's end.

Source:  Thomas Voting Reports Inc.
http://www2.journalnow.com/news/2012/mar/25/wsmet07-roll-call-votes-in-congress-ar-2084633/