House Chairman Calls For ObamaCare Watchdog

The Obama administration has spent billions of taxpayer dollars implementing the Affordable Care Act, often taking vast liberties with statutory language. The administration’s actions were the subject of a House Ways and Means Oversight subcommittee hearing on Wednesday, chaired by Rep. Peter Roskam (R-IL).

Roskam is calling for a Special Inspector General to investigate the administration’s actions and track how tens of billions of dollars have been spent. Implementation of the sweeping and complex law stretches across eight separate federal agencies so no one agency IG can see the patterns and possible abuses taking place.

Rep. Roskam’s SIGMA Act (Special Inspector General for Monitoring the Affordable Care Act) would create an ObamaCare watchdog to conduct much-needed audits of the ACA to guard against further waste of tax dollars, such as the extraordinarily expensive and problem-prone exchange websites.

I testified before yesterday’s hearing, citing our work chronicling 31 instances in which the administration has issued regulations or guidance that conflict with the language of the statute.

While the ACA has caused enormous disruption to our health sector and economy, these problems have been exacerbated because the administration has played fast and loose with its executive authority. Rather than abide by the law or ask Congress to amend it, the administration has instead made significant changes through regulation, guidance, and even blog posts.

50 changes to ObamaCare…so far

The Galen Institute has tracked the major changes made to the ACA since it was enacted five years ago, and we count at least 50 changes – 31 by the administration, 17 passed by Congress and signed into law by President Obama, plus two changes made by the Supreme Court.

One of the most prominent examples is before the U.S. Supreme Court in the King v Burwell case, challenging the IRS regulation that extended premium tax credits to people enrolled in insurance through federal exchanges, even though the statute only allows the subsidies if states create their own exchanges.

Jonathan Adler of Case-Western Reserve University School of Law and Elizabeth Papez, former deputy attorney general, discussed at length the legal considerations in that case and other actions the administration has taken without statutory authority.

I focused in my testimony on additional examples of actions clearly contrary to the statute – such as allowing people to “self-attest” to their eligibility for subsidies in the exchanges and the blatant disregard for statutory trigger dates in delaying the employer mandate.

I also highlighted illegal bonus payments the Obama administration has made to try to postpone cuts required by the law to the popular Medicare Advantage plans for seniors. The nonpartisan Government Accountability Office called for the administration to cancel an $8.3 billion program it has tapped to pay “quality bonuses” to Medicare Advantage insurance plans – plans often rated average, at best. The administration has ignored calls from the GAO and from Congress to stop the illegal payments.

Lack of transparency

The administration also has been criticized for its lack of transparency in its financing of the implementation of the law. For example:

Co-op funding: The administration last year provided $300 million in “solvency funds” to co-op health plans. There has been no explanation of the criteria used to give some co-ops added funding and others little or nothing.

Costsharing reductions: Ways and Means Chairman Rep. Paul Ryan asked Treasury to explain $3 billion in payments made to health insurers for cost-sharing reductions, spending never authorized by Congress. The issue is part of the lawsuit filed by House Speaker John Boehner. The administration claims the payments are legal, but it undercut its own argument when HHS asked Congress for appropriations to finance the payments. Congress rejected the funding request, but the administration paid insurers anyway.

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About the author

Grace-Marie Turner is president of the Galen Institute, a public policy research organization that she founded in 1995 to promote an informed debate over free-market ideas for health reform. Full biography