Health Care News (Heartland Institute), December 16, 2009

Legislative proposals under consideration in Washington, DC could dramatically expand the size and authority of government agencies, and not merely those traditionally focused on health care.

While the Department of Health and Human Services (HHS) would expand significantly under any of the federal health care reforms currently under consideration, a possible compromise measure could also saddle the Office of Personnel Management (OPM) with administering a public health plan for the entire population, necessitating a massive increase in size and budget.

Expanded Powers, Duties

Under the health care legislation passed by the House of Representatives, HHS Secretary Kathleen Sebelius would have a greatly expanded set of duties and authority, including the power to mandate the type of medical care, rates, and term between insurers and patients.

Jeffrey Anderson, a senior fellow in health care studies at the Pacific Research Institute in San Francisco, believes HHS’s expansion in authority and size is inevitable under the House plan.

“Medicare is housed at the U.S. Department of Health and Human Services (HHS), so if Democrats choose to expand Medicare eligibility, as has been proposed, down to the age of 55, HHS’s size would expand along with Medicare and the national debt,” Anderson said. “It would be impossible to stop the growth.”

New OPM Role

While HHS is traditionally focused on health care, Senate Democrats propose the OPM, a smaller agency which currently administers the Federal Employees Health Benefit Plan (FEHBP), be tasked with providing the same service for a significant portion of the general public. The director of OPM reports directly to the President, and the agency is currently structured to deal exclusively with government employees.

Michael Franc, vice president of the Heritage Foundation, doesn't believe OPM is capable of effectively extending past the federal workforce.

“A number of past OPM Directors do not like this proposal, and they've said that OPM would not be able to handle the additional workload,” Franc said.

OPM currently manages the system for a comparatively homogenous group of federal employees, in a very lightly regulated system with virtually no real mandates on coverage. Expanding their purview to the population as a whole could be challenging.

“The companies that take part in the FEHBP are basically free to design plans based on what market conditions would dictate to attract customers without much regulation,” Franc said. “And federal employees actually like it that way. But this solution could raise more problems than it solves.”

‘Goal Is to Expand Government’

Anderson believes the OPM option could be a fallback position for the White House if a true public option fails.

“This all goes to the main idea of the President’s notion of health-care reform,” Anderson said. “The goal is to expand the reach of the federal government and the scope of power in Washington over your health.”

Loren Heal (loren.heal@gmail.com) writes from Neoga, Illinois.