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The Apothecary

 

Unpublished CRS Memo: Obama Administration Has Missed Half Of Obamacare's Legally Imposed Implementation Deadlines

August 18, 2013

By Avik Roy

In recent months, President Obama and his subordinates have waived or delayed a number of Obamacare’s notable features, such as the law’s employer mandate, and its procedures for protecting taxpayers from fraud and identity theft. Earlier this month, in that context, I obtained a heretofore-unpublished memorandum from the Congressional Research Service. The CRS, Congress’ non-partisan in-house think tank, compiled 82 deadlines that the Affordable Care Act mandates upon the first three years of its own implementation. Remarkably, it turns out that the White House has missed half of the deadlines legally required by the ACA. And some of those deadlines remain unmet to this day.

The new CRS memo, dated June 5, 2013, is an addendum to a series of previous reports in which the agency examined missed deadlines during the law’s first two years. The CRS excluded from its analysis deadlines that don’t reflect on the administration’s competence; for example, as states expand Medicaid, the federal spending associated with those expansions occurs more or less automatically. Deadlines that the law imposes on non-federal government actors, like state governments and private companies, were also excluded.

41 out of 82 deadlines missed by the administration

As of May 31, 2013, when the CRS analysis was completed, the White House had yet to meet 9 of 12 deadlines from the first year after the Affordable Care Act was enacted. It failed to meet 22 of 53 deadlines in the second year; another 8 became moot after Congress did not appropriate funds to complete the assigned tasks. In year three, the administration missed 10 out of 17 deadlines. That’s a total of 41 out of 82 deadlines missed.

If you exclude the 9 deadlines that became moot because Congress never appropriated the funds to meet them, the Obama administration missed 41 out of 73 deadlines, or 56 percent.

In analyzing the CRS report, I erred on the side of generosity. If the administration missed a particular statutory deadline by a week or less, I counted it in their favor as a “met” deadline. In any case where there was ambiguity in the CRS report, I assumed that the administration had met the deadline. So these 50-56 percent missed deadline figures should be seen as slightly conservative.

Most of the deadlines are for bureaucratic busywork

Most of these deadlines aren’t for mission-critical features of the law, and the document reads like a kind of caricature of bureaucratic busywork. For example, Section 10407(d) mandates that by March 23, 2012, the Secretary of Health and Human Services is required to “submit to Congress a report on the appropriate level of diabetes medical education.” To date, the report has not been located. Also on that date, the Secretary is required to “implement a 5-year national public education campaign on oral health care prevention and education.” She missed that one too.

But there are some more economically significant deadlines that the administration has missed. A requirement for the Secretary to “develop requirements for health plans to report on their efforts to improve health outcomes,” also due on March 23, 2012, has not been met to date. A number of rules that would safeguard the privacy of medical records have either yet to be developed, or have been meaningfully tardy in their arrival.

And, of course, if you follow the Obamacare news, you are aware of the high-profile delays that are not included in the CRS report, such as the delay in Obamacare’s caps on out-of-pocket insurance costs.

The administration has tried, almost comically, to make the case that the faulty implementation of Obamacare is Republicans’ fault. But blue states that have embraced the law are the ones having the most problems.

Kevin Counihan, chairman of the Connecticut insurance exchange, has publicly expressed his frustration with the Obama administration’s flakiness. “Sometimes it feels like we’re driving a car and then changing the tire at the same time,” he told the Associated Press in March. “We’re going to have a challenging enough time providing the quality of service that our residents deserve in Connecticut with the deadline that we have. If they keep adding new regulations, I’m sorry. We have to suddenly say, ‘enough is enough.’” Counihan is one of the many people trying in good faith to implement the law who says, “I wish we had one more year.”

No, Obamacare isn’t unraveling

We should make one thing clear. The law isn’t going to “collapse unto itself” or any such thing that conservatives appear to pine for. For every missed deadline or White House waiver, there are nine aspects of Obamacare that are being implemented as we speak.

Obamacare may fail at reducing insurance premiums, or at wisely using taxpayer funds. But the law is scheduled to spend $1.9 trillion over the next ten years. At that, it is unlikely to fail.

A significant amount of that money may not go to the people for whom it’s intended. It may not have the benefits on health outcomes that the law’s most zealous supporters insist it will. But barring substantial Congressional action, that $1.9 trillion will still get spent, along with trillions more thereafter. Only new laws, not wishful thinking, will change that.

Original Source: http://www.forbes.com/sites/theapothecary/2013/08/18/unpublished-crs-memo-obama-administration-has-missed-half-of-obamacares-legally-imposed-implementation-deadlines/

 

 
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