THE TREATMENT SEPTEMBER 14, 2009
Though he’s the second-ranking Democrat on the Finance Committee, Jay Rockefeller has had a hard time being heard in the health care debate. The West Virginia Senator has positioned himself to the left of the Gang of Six, the bipartisan group with which Chairman Max Baucus has been negotiating legislative language. In particular, Rockefeller has openly attacked Kent Conrad’s co-op plan and unabashedly defended partisanship as the route to real reform. By and large, these criticisms haven’t made a huge difference; notwithstanding Rockefeller's protests, the framework Baucus put out two weeks ago scales back the boldest reforms put forth in the HELP and House bills. But there’s one issue, at least, where Rockefeller seems to have made headway: Baucus has indicated that he wants to adopt what’s become Rockefeller’s signature idea--an independent Medicare advisory commission (IMAC) that work to eliminate Medicare fraud and mismanagement.
It’s an idea that’s been roundly criticized by both the right and left for ceding power from Congress to an independent body. Almost no legislators besides Rockefeller and Representative Jim Cooper have stepped forward to support such a panel; the House Democratic leadership has been vocal about disdaining the idea. Back in July, the Congressional Budget Office declared that there the proposed commission would deliver far less than the promised savings (although that may have reflected the particular design it considered). Given the hysteria of August, proposing that an independent commission of technocratic experts—dare we call it a “panel”—take the lead in reforming Medicare, outside the immediate jurisdiction of Congress, would seem to invite more trouble.
But IMAC is important enough to the Obama administration (particularly OMB director Peter Orszag) that they’ve talked it up every step of the way; Obama mentioned it in his speech last week. Rockefeller, in turn, has reached out to the White House--as used it as a way to channel the message to Baucus, a Democratic Senate aide tells me. Now it seems likely Baucus will keep some version of the idea when he unveils his final proposal, perhaps as early as tomorrow. “It’s not the exact thing he proposed,” says the aide. “But the fact that it’s included is a big success [for Rockefeller].”