Background: Health Care “Reform’s” Timetable the Last Time Around
As Democrats on the three key Committees with health care jurisdiction (Education and Labor, Energy and Commerce, and Ways and Means) prepare for possible markups on health “reform” legislation next week, it’s instructive to examine the way in which the Clinton health care proposals were considered — which is to say, in a much more deliberative fashion. While the Energy and Commerce Committee never marked up the Clinton bill (H.R. 3600 in the 103rd Congress) — because then-Chairman Dingell could not procure a majority for passage at either the Subcommittee or full Committee level — other House Committees embarked on an intense process of scrutinizing legislation over many weeks and months:
- The Education and Labor Committee spent 11 days marking up at Subcommittee, and a further 7 days marking up at full Committee, resulting in markup consideration that lasted for over two months (April 21 through June 23, 1994);
- While the Ways and Means Committee spent only one day considering the bill within the Health Subcommittee, the full Committee markup lasted 17 days over six weeks (May 17 through June 30, 1994);
- The Ways and Means Committee held a dozen hearings (eight at Subcommittee, four at full Committee) on the bill after its introduction — not counting the 32 additional hearings the full Committee and two of its Subcommittees held during the course of 1993 before the Clinton bill was formally introduced;
- All told, 14 Subcommittees across nine standing Committees held a total of 21 hearings (16 Subcommittee, 5 full Committee) and 46 days worth of markups (16 Subcommittee, 30 full Committee) on the Clinton bill after its introduction.
It’s also worth pointing out that the first Subcommittee markup came on March 23, 1994 — more than four months after the Clinton bill was introduced on November 20, 1993. That markup also came several weeks after CBO released a comprehensive, 104-page analysis and score of the Clinton health bill (which is still online and can be viewed here).
The openness of the process with which Democrats intend to consider their current “discussion draft” pales in comparison to the rigor of the scrutiny placed on the Clinton bill. The three Committees all intend to bypass Subcommittee consideration, and consider the bill simultaneously in full Committee next week — with some markups possibly only lasting one day. The three Committees combined could spend less time marking up the bill than the Education and Labor Committee did on its own in 1994 — and the 19 total hearings held by the three Committees both before and after the “discussion draft” was released would not begin to match the 26 hearings held by a single Ways and Means Subcommittee before the Clinton bill was ever introduced. Lastly, even with unemployment now at 9.5%, the Ways and Means Committee has yet to release plans outlining the tax increases necessary to finance health “reform” — and has no plans to hold even a single hearing on the impact these job-killing taxes would have on the American economy and employment.
Finally, it should be noted that not only has CBO yet to score the House “discussion draft,” it also has yet to release a complete score of health legislation, similar to the analysis of the Clinton legislation released in February 1994. Such an analysis would include, among other things, these factors that have not yet been publicly analyzed by CBO for any of the bills being considered:
- Whether any of the bills will actually reduce health care premium costs when compared to current baseline projections;
- The potential job losses from the bill’s provisions — including employer mandates, other tax increases, and the “crowd-out” of private-sector borrowing by any new Treasury lending necessary to finance the program;
- Whether legislation will be balanced beyond the 10-year budget window — or whether the proposals would create a funding “cliff” that will result in significant unfunded obligations for future generations;
- Which portions of health reform legislation will be classified as “on-budget” — an important judgment reflecting CBO’s opinion as to whether or not the health insurance industry will be effectively nationalized; and
- Whether CBO prices in a risk that the government-run health plan will go bankrupt, or whether CBO believes that, like Fannie Mae and Freddie Mac, the government-run plan (or a co-op) would be bailed out by taxpayer dollars — thus creating a distinctly un-level playing field between private coverage.
In other words, not only is the process more rushed than the 1993/94 Clinton plan, but Members have less information with which to analyze the bill. Of course, according to some Democrats, these actions are by design, as Tom Daschle has noted: “I do not believe we should draft a bill laying out this vision in excruciating detail.”
The potential size and scope of health legislation — more than one-sixth the American economy, impacting each and every American — argues for a deliberative process on this issue above all others. Unfortunately, Democrats appear determined to ensure that will not occur — and the American people may well end up the poorer for it.