Critics say missed deadlines and other signs show the Obama administration is stumbling out of the gate on its early steps to implement the president's health-care law.
The Department of Health and Human Services (HHS) has already missed as many as four deadlines under the law – not on any major regulations — but still a worrying trend, critics say.
Congressional staff and industry representatives have also been asking HHS for a timeline specifying when it will issue the numerous regulations required by the law. They were shocked to find the agency has not produced such a document, one aide said.
The issue is important because vast industry sectors are trying to plan their own implementations of the health-care law and most of the details remain in bureaucrats' hands, leaving a vacuum of uncertainty about the final burdens the law will impose.
The missed deadlines include creating task forces on breast cancer and Alaskan health care, publishing a list of new authorities granted under the law, and setting a schedule for a Government Accountability Office study and financial audit.
HHS spokeswoman Jessica Santillo noted the administration had already implemented numerous parts of the health care law in advance of deadlines.
"HHS has been working to get the benefits of the new law to the American people as quickly as possible which is why several important benefits are taking effect well in advance of their deadlines, such as ending the practice of rescinding coverage of Americans who get sick, and allowing young adults under 26 to stay on their parents coverage," Santillo said.
She defended the administration's approach on one of the missed deadlines – a requirement under the health-care law that HHS publish "a list of all of the authorities provided to the secretary under this act" on its website.
Santillo pointed The Daily Caller to a page listing the names of sections in the law, such as "Sec. 1562. Conforming amendments."
Republican critics say the list, which links to parts of the actual bill text, doesn't meet the letter or spirit of the law's requirement, which is included in a section of the law titled, "Transparency in government."
"Now it looks like the simplest job assigned to the Obama administration – outlining its own new authorities and responsibilities — was so daunting that HHS decided just to reprint the table of contents from the new law until they can sort things out," said Lisa Miller, a spokeswoman for Rep. Joe Barton of Texas, a key Republican on health-care issues. "It's troubling because, if they can't even explain what they are supposed to do, how do we expect them to actually manage a sixth of the economy?"
While missing the deadlines, the administration has found time to send promotional material touting the law's benefit, including a brochure for senior citizens and post cards from the IRS advertising tax breaks under the law.
The brochure for seniors may improve the law's perception among lawmakers – the 111th Congress is the oldest in history by average age – but it is not assuaging some Republicans who call it propaganda.
"Despite the fact that they don't know what they are even in charge of, the IRS can send out postcards touting the tax credits, they can hire a health-care cheerleader and they can send out CMS brochures – talking about things that don't even apply to seniors?" a key GOP aide said.
Tevi Troy, the former deputy HHS secretary for President George W. Bush, says the administration is facing a daunting task in implementing the law. Troy is now a senior fellow at the Hudson Institute.
"It's huge, there's a lot to do," Troy said, "HHS is really on the line here."
Troy said the early missed deadlines are not on significant issues, but that they may point to a troubling trend. Far more important are 12 significant regulations that are to be proposed by Sept. 23, Troy said.
One thing complicating the picture is that critics of the missed deadlines are wary that highlighting the issue may provoke HHS to rush, Troy said, potentially leading to errors and unforeseen consequences.
Further, the White House Office of Management and Budget (OMB), which reviews all regulations before they are finalized, may not have enough time to do a proper review in that case, Troy said. Historically, OMB has tended to push regulations in a conservative direction.
Another factor making the job harder for HHS is that the health-care law's deadlines are coming faster than Congress intended. After Scott Brown was elected to the Senate, congressional Democrats passed a Senate-passed bill in the House without any revisions – months after the Senate had passed the bill. If they hadn't been forced to take that route, the bill's deadlines would have likely been updated to reflect the passage of time, Troy said.
One example of this is a deadline for an advisory committee to issue a progress report on deciding what counts as "medically underserved populations and health professional shortage areas" that receive extra federal money.
The progress report was due April 1, nine days after the president signed the health-care bill into law. But HHS is also required to give the public 30 days to comment on the membership of the advisory committee. The comment period ends June 10, until which the advisory committee cannot exist.
In other words, it was legally impossible for HHS to meet the deadline.
The full list of missed deadlines includes:
- April 1: Under section 5602, a progress report to HHS Secretary Kathleen Sebelius regarding developing a methodology for designating medically underserved populations and health professional shortage areas.
- April 22: Under section 1552, HHS must publish a list of new authorities it was granted by the health-care law. (Note: HHS says this deadline has been met).
- May 7: Under section 5104, HHS is to establish a task force on improving health care in Alaska.
- May 23: Under section 399NN, HHS is to establish a task force on breast cancer, part of legislation originally titled the EARLY Act.