A Lame Duck Managing an $800 Billion Budget?
You may have seen the Politico story late last night indicating that Finance Committee Chairman Baucus is uncertain as to whether or not he’ll bother to schedule confirmation hearings for Centers for Medicare and Medicaid Services Administrator Donald Berwick. While this development is not particularly surprising – the controversial nominee’s views prompted President Obama to circumvent the Senate confirmation process and issue Dr. Berwick a temporary recess appointment last July – it does say much about the continued lack of transparency and accountability within the Obama Administration.
The job of CMS Administrator is far from inconsequential – in fact, it’s one of the most significant in the entire federal government. Last fiscal year, CMS disbursed $803 billion in benefits – making the agency larger than the economies of Finland, South Africa, and Israel combined. The agency will implement most of the health care law’s 2,700 pages, and will issue thousands more pages of regulations to implement the statute. CMS directly manages the health care of more than one in three Americans – and its insurance office indirectly manages through regulation the health care of virtually every other American.
It’s also worth pointing out that CMS hasn’t had a Senate-confirmed Administrator for nearly five years. Senate Democrats refused to bring Kerry Weems, President Bush’s replacement for Mark McClellan, up for a vote during the 110th Congress. More recently, President Obama dithered for 454 days –nearly 15 months – before nominating Dr. Berwick to head the agency. Dr. Berwick’s current recess appointment expires at the end of the year – but the Politico story suggests that Democrats don’t believe Dr. Berwick will be able to win confirmation.
The questions here are obvious: How much longer will such an important agency be headed by an individual who has not been subject to Senate scrutiny and accountability? If even Chairman Baucus admits – as his statements below imply – that Dr. Berwick does not have the support to win confirmation, what will he do to ensure the Administration submits a nominee who can be confirmed? Or is the plan to allow Dr. Berwick to continue running an $800 billion agency – issuing thousands of pages more regulations – even though Democrats themselves concede he has become a politically controversial lame duck?