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Posted at 5:10 PM ET, 01/24/2011

Should the Affordable Care Act have bipartisan oversight?

By Ezra Klein

The New York Times asked Tom Daschle to weigh in on what Barack Obama should say about health-care reform at the State of the Union. Daschle offered up some boilerplate, and then this:

I propose that we create a bipartisan commission to examine the best ways to carry out, oversee and, where appropriate, revise the health care reform law. Made up of members of Congress, governors and members of my administration, this commission would provide invaluable guidance and solutions going forward.

I think this is a bad idea, but I'm not totally sure I'm right. The case for it is clear enough: Most Americans believe we should have some sort of reform, and they'd prefer to see the Affordable Care Act tweaked than repealed. If Obama shows he's willing to do that, and Republicans show that they aren't, that might highlight the fundamentally unreasonable stance the GOP has taken.

The case against it, however, is even clearer: Most Republicans believe we should have full repeal, not tweaks, and would use both the announcement of the commission and the commission itself to prosecute their case. Republicans would start by saying that this shows even the president thinks the law is fatally flawed in its current form. If they then agreed to participate, Boehner and McConnell would not appoint Mark McClellan and Ross Douthat and Scott Brown and Bill Frist. They'd stock the committee with media-hungry up-and-comers who're charged with using their position on the "inside" of the legislation to bring down the bill. Those members would coordinate with the rest of the party to argue that the law is flawed beyond repair, and needs to be repealed. And on it would go.

The pity is, I'd actually like something of this sort to be possible. And perhaps it would be. The president could just name a bipartisan commission of his choice, including Republican health-policy experts like McConnell and Frist, who're critical of, but willing to live with, the legislation. But that would probably defeat the point of the exercise. Or perhaps it would empower some new voices in the debate who would be helpful in moving us past the dead-end of repeal and toward watchful implementation and continuous reform. What do you think?

By Ezra Klein  | January 24, 2011; 5:10 PM ET
Categories:  Health Reform  
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Next: Reconciliation


bipartisan oversight?

How about repealing it

And starting over with a bill with BIPARTISAN SUPPORT ....


Posted by: SunlightandLowTaxes | January 24, 2011 5:33 PM | Report abuse

Agree with you - bad idea. And how can you mention the whole idea without mentioning that Tom Daschle is corrupted by health care lobbying dollars, and may have been talking to the times in his capacity as a health care lobbyist?

Please don't sink to the level of the rest of the Post - the newspaper of record in a one-industry town - the industry being the sale of the public interest to corporations.

Posted by: Dollared | January 24, 2011 5:38 PM | Report abuse

"Continuous reform?" Is that like "Perpetual Revolution?"

Posted by: ath17 | January 24, 2011 5:39 PM | Report abuse

Democrats, including Obama, have freely admitted the Affordable Care Act is not perfect and needs improvement. If the Republicans want those quotes for ammunition, they already have them.

Aside from that, having a bipartisan commission would simply be the right thing to do, even if it is not good politics. Ezra himself has said this law will need to be tweeked, expand what works, change or remove what does not. Obama has proven he is willing to do something unpopular or bad politics, if it is the right thing to do.

What the Republicans really need to do is focus on their cost control measures and put forth a supplemental bill aimed at controlling costs. People will be happy with them for reducing costs and they can probably do so without increasing the deficit because the Affordable Care Act already took care of the expensive part. The government is spending more on health care because of subsidies in PPACA, if the Republicans lower health care costs with a new bill, it would probably lower the deficit by quite a bit.

I would also think they stand a good chance of getting enough support from moderate Senate Democrats and Obama to get a bill signed into law.

PPACA is taking care of providing near universal coverage and the Republicans' bill can take care of reducing costs. This would be what is best for the country.

Posted by: DeanofProgress | January 24, 2011 5:47 PM | Report abuse

I'm of the school of thought that the biggest political problem with health care reform was that people experienced it as unrelated to the central issue that they wanted politicians to focus on, which was economic performance and jobs. People were happy about Obama when the story was a FDR-style campaign to improve a bad economy; they grew frustrated when they started seeing him pursuing a generic liberal objective. From that perspective, promising a whole new damned Commission to study it and come up with a whole new set of fixes is the opposite of the solution.

The best way to defeat GOP efforts on health care repeal is not to promise incremental reforms to the project, but to change the conversation to jobs, economy, international competitiveness, etc. Then when the GOP keeps trying to push repeal, or starts doing aggressive things to the budget to make reform impossible to implement, they look like the people obsessed with some partisan thing irrelevant to the main question of the day and Obama looks like the guy trying to bring people together around improving the economy.

By 2012, I expect health care reform to be a secondary issue in the Presidential election.

Posted by: satya232 | January 24, 2011 5:49 PM | Report abuse

Sure, the health reform law could use some tweaks, but I'm pretty skeptical that this is the way to do it. Creating a bipartisan commission sounds like it would be largely symbolic, and would sap time and energy from more important initiatives going forward.

Posted by: madjoy | January 24, 2011 5:54 PM | Report abuse

the 'up and commers'? as opposed to Chuck "Don't pull the plug on Grandma" Grassley?

The GOP is corrupt top to bottom. I won't say the Dems are squeaky clean, but generally speaking they actually try to help all the people of American, not just the fat cats. (I'll take that over tax cuts for billionaires any day.)

And yes that even includes the Red Staters crying the gov't takeover of health care whilst chanting "Hands off my medicare".

Posted by: rpixley220 | January 24, 2011 6:13 PM | Report abuse

I'd agree only if Jon Stewart were the commission's chairman and its meetings were held before a Comedy Central audience. Then it might be worth hearing what Republicans might have to say.

Posted by: tomcammarata | January 24, 2011 6:25 PM | Report abuse

I'd agree only if Jon Stewart were the commission's chairman and its meetings were held before a Comedy Central audience. Then it might be worth hearing what Republicans might have to say.

Posted by: tomcammarata | January 24, 2011 6:26 PM | Report abuse

Yes, bad idea. The Republicans don't have even the concept of concrete improvements. The ACA is their concept, after all, as you have pointed out. There is no balm in Gilead. And there is no good faith in the Republican Party.

Posted by: jtmiller42 | January 24, 2011 6:27 PM | Report abuse

Lock the bipartisan commission in the room and don't send in food until they agree on an improvement.

We might get something that works that way... or a few new vacancies.

Posted by: will12 | January 24, 2011 6:32 PM | Report abuse

What do I think? I think any thing that you support has got to be a bad idea! Your progressive buddies are loving the up-tick in Obama ratings, but, not to worry, they will fall again!

Posted by: my4653 | January 24, 2011 7:01 PM | Report abuse

A commission? How about we just implement the law because it was passed by both houses of Congress and signed by the President, just like any other law. Let's stop allowing the right wing characterize healthcare reform as some kind of mistake. It passed, the opponents lost. Get over it. We can change it once changes appear necessary, but implementation has barely begun.

Posted by: spekny | January 24, 2011 8:01 PM | Report abuse

Hey Charlie Brown: Lucy will always have a football for you.

Posted by: RZ100 | January 24, 2011 8:03 PM | Report abuse

When the provisions of the Affordable Care Act go fully into effect in 2014, we will be able to see what works and make intelligent tweaks to the law. Until then, the only tweaks we can make would be based on things we already knew when the law was written. For example, we know that a public option would make the bill better, or at least not make it worse, so it's a no-brainer from a policy perspective. But the political landscape has not improved, so I'm not sure it's worth making another attempt to pass a public option.

Bottom line: wait until 2014, and then decide whether a bipartisan commission makes sense based on the politics at the time.

Posted by: KennethAlmquist | January 24, 2011 10:50 PM | Report abuse

Weren't new voices already "empowered" at the health reform summit the president called back in 2010? Remember that seminar, where the President declared whether people's ideas were "legitimate", or just "talkin' points", "campaignin'" (John -- not senator -- the campaign is over), "bickerin'", or some other phrase for intolerable dissent.

Posted by: truck1 | January 25, 2011 8:32 AM | Report abuse

Here's where the hypocrisy of Democrats is exposed. If they really believe PPACA wasn't perfect to start with, and that there are 'tweaks' that now need to be made, then why pass it in the first place and keep lying to people about how it will 'reduce the deficit'?

It really wouldn't have been that hard....introduce a two-page bill that bans insurance companies who operate in the U.S. across state lines from denying insurance for pre-existing conditions. That's it. Vote up or down.

Now move to the next one....introduce a 2 page bill that requires insurance companies to expand coverage for children up to age 26. That's it; vote up or down.

And on and on they could have gone....that process would have given us the good parts, without all the corrupted parts that now need to be "tweaked". Instead, Democrats gave us a 2,000 page bill with lots of sludge buried in it that now threatens to sink any real 'reform'.

The best course is to fully repeal PPACA, and start over with legislation that would fix piecemeal the flaws with our current health care system....instead of passing a radical one-sided, completely partisan overhaul that may adversely affect all citizens for decades to come in order to expand health care coverage to 5% (at best) of our population.

Posted by: dbw1 | January 25, 2011 9:10 AM | Report abuse

I'm debating whether to support this call for a bipartisan panel. Ezra, would this panel be using real math to estimate actual costs and revenues of the PPACA, or will they be using progressive/CBO math that woefully underestimates costs and overestimates revenues?

Posted by: dbw1 | January 25, 2011 9:13 AM | Report abuse

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