It is becoming increasingly hard to tell whether Obamacare is the law of the land, or just the law of the parts of the land that don’t reside in (or aren’t in the good graces of) the executive branch. One wonders: Is it really too much to expect an administration that championed the passage of a 2,700-page overhaul of American medicine to live by the same law it was so eager to impose on others?
The Congressional Research Service (CRS) has just released a memo (posted here at the 2017 Project) listing deadlines that Obamacare imposed on the Obama administration—or, if you prefer, that the Obama administration imposed on itself through Obamacare—and reporting whether the administration has met them or not. To date, it appears that the administration has missed 25 deadlines that it was required, as a matter of law—as a matter of the president’s signature law—to meet.
For example, the CRS writes that Obamacare “[r]equires the Interagency Working Group on Health Care Quality, convened by the President and chaired by the HHS [Health and Human Services] Secretary, to submit to Congress, and publish on the Internet, a report on its progress and recommendations.” Even though that report was due on New Year’s Eve 2010—1,206 days before the April 21, 2014 date of the CRS memo—the CRS writes, “No report has been submitted to Congress.”
The CRS writes that Obamacare “[r]equires the HHS Secretary to develop requirements for health plans to report on their efforts to improve health outcomes, prevent hospital readmission, ensure patient safety and reduce medical errors, and implement wellness and health promotion activities,” while it also requires HHS “to promulgate regulations that provide criteria for determining reimbursement structure to improve quality.” But even though the deadline for completing these tasks was March 23, 2012—the 2-year anniversary of Obamacare (which is now more than four years old)—“No public information has been released.”
Obamacare “[r]equires the CDC [Centers for Disease Control and Prevention] to conduct a national survey of employer-based health policies and programs.” Yet more than two years after the March 23, 2012 deadline for doing so, “CDC is exploring the feasibility of conducting this survey.”
Obamacare “[r]equires the HHS Secretary to publish a final rule (incorporating public comment on an earlier interim final rule) on a comprehensive methodology and criteria for designating medically underserved populations and health professions shortage areas.” Yet 1,025 days after the July 1, 2011 deadline, “A final rule has yet to be published.”
In the realm of Indian health, Obamacare “[r]equires the HHS Secretary to submit a report to Congress on protocols, policies, procedures, and other programs for victims of domestic or sexual violence.” The CRS writes, “IHS [the Indian Health Service] informed CRS on Apr. 15, 2014, that the report is completed”—yet, more than two and a half years after the report was due (on September 23, 2011), it still hasn’t made it through “the IHS clearance process” and hence still hasn’t been submitted.
Most Americans have somehow managed to live full lives without the government having undertaken any of these actions, and many if not most Americans would probably prefer that the government not undertake these actions (at taxpayer expense). Regardless, President Obama and his congressional allies collectively thought that each of these things was important enough to add yet another paragraph, or yet another page, to the bloated epic/tragedy that is Obamacare. And they required, by law, that the executive branch fulfill these tasks on schedule.
Under the Constitution, the executive power is vested entirely in the president. The least that President Obama could do is fulfill the legal requirements of a law he spearheaded and signed.
Jeffrey H. Anderson is executive director of the 2017 Project, which is working to advance a conservative reform agenda, including a Winning Alternative to Obamacare.