Super Congress v. IPAB

NY Times has published a short story on the 12 member Super Congress made up of sitting Representatives and Senators that must propose a $1.5 Trillion deficit reduction by Thanksgiving. Their proposal will be receive preferenced voting status or unpalatable budget cut triggers will go into effect.

Here is a roundup of posts I have written on IPAB, which is a part of the ACA. It would recommend payment reductions in Medicare if overall Medicare growth targets were not met. There are many similarities between IPAB and the Super Congress, with the main difference being that the Super Congress is more powerful than IPAB, and the fact that all 12 members of the Super Congress are elected members of Congress and not appointed by the Executive Branch and confirmed by the Senate (as with IPAB).

A couple of points about the Super Congress:

  • If the Super Congress just shaves $1.5 Trillion in deficit reduction from an otherwise unchanged whole (meaning tax system, health care, Social Security), that is still not going to provide a long term sustainable budget.
  • If you ever want a sustainable budget, you have to have a robust health reform plan. The ACA is a start, but we need to do more and it is the only plausible vehicle we have (keep the numbers 218, 60 and 1 in mind which is what it normally would take to repeal or tweak the ACA).
  • The Republicans have been free riding on the anger generated by the ACA. By that I mean they have no credible health reform plan, certainly not one that can address cost and coverage concerns. So long as they have no health reform plan, they do not have a credible long term deficit reduction strategy to move us toward a sustainable budget over the next 30-40 years.
  • No, they have the Ryan plan, you say? Two points: First, it is a Medicare and Medicaid reform plan that repeals the entirety of the ACA coverage expansions, meaning there would be 32 Million more uninsured in 2021 than there would be by default now. It is possible that is their ultimate plan for the 2012 election (focus Medicare and Medicaid only while not addressing coverage issues), but I don’t think that will work politically. Much of the public believed them when they promised the replace part of their pledge to ‘repeal and replace’. Second, the House committees that will have to consider and mark up the detailed Medicare portions of the plan haven’t done anything on them yet so far as I can tell. Until they pass the details out of at least one of these committees it is not a plan so much as it is a fantasy.

The country needs a political deal on health reform so that we can move ahead and address health care costs. It will be a 30-40 year struggle to get a sustainable health care system. The Super Congress is the last chance for this Congress to do anything consequential policy wise. Here is hoping they will not only tinker around the edges but seek a plan that could transform health reform for a toxic partisan battle into a something that both parties can get some credit for. Most importantly, let’s hope we can come to some way forward in which both parties will share responsibility for improving the health care system. It is a long shot, but we really do need a Super Congress that thinks big.

update: this one wasn’t my best and had lots of errors. More coffee, less rush needed. Sorry about that.

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