May 10, 2012
First, we had banks that were too big to fail. Now, we have government that’s too big to control. That’s the label House Republicans slapped on the Department of Health and Human Services on Wednesday during a hearing on the agency’s spending.
GOP members of the Energy and Commerce Committee’s oversight subcommittee took turns shredding HHS spending on international travel, the agency’s growing payroll, funds purportedly used for spaying and neutering dogs, and decisions to ignore Government Accountability Office recommendations to eliminate ineffective programs.
“It does appear that HHS is now too big to control,” said Rep. Marsha Blackburn (R-Tenn.). “It is very evident to us that you are too big to manage. You are too unwieldy. … You are spending money in ways that you ought not to be spending it.”
Norris Cochran, deputy assistant secretary of budget for the HHS, told committee members sharp increases in the number of full-time employees within the agency in recent years are largely attributable to ramped-up staffing at the Food and Drug Administration and the Indian Health Service. He also described efforts to eliminate paper files and consolidate data-collection functions of the FDA and the Centers for Disease Control and Prevention.
Not mentioned in that discussion was the creation of the Center for Consumer Information and Insurance Oversight—the agency the HHS set up to implement the health reform law. A pair of GAO employees, seated alongside Cochran, described offering a slate of recommendations to the HHS to save billions of dollars. Some, they said, have gone unheeded. “There’s always more to do,” said Carolyn Yocom, GAO healthcare director.
Democrats on the subcommittee used the hearing to tout provisions of the health reform law they said helped the HHS crack down on Medicare fraud and to reject a Republican budget they argue would gut safety-net programs.
Republicans spent the two-hour hearing on a litany of complaints, hitting the HHS on everything from high salaries to travel expenses. The panel’s chairman, Rep. Cliff Stearns (R-Fla.), pointed out that 90 of the 100 highest-paid civil servants work for the agency.
Although Rep. Jan Schakowsky (D-Ill.) noted that the agency’s travel budget had decreased from its level during the Bush administration, Rep. Joe Barton (R-Texas) wondered whether international travel within the agency—$65 million in 2011—could be trimmed by inviting foreign officials to the United States “on their dime.”
“We’ve all seen the reports in the last several months about some of these abuses of public funds—the GSA, their trips to Las Vegas, the Secret Service and their escapades down in South America,” he said. “We all hope those are exceptions and not the rule. But I look at HHS, and … it’s an agency that’s almost uncontrollable.”
Cochran deflected some of the Republicans’ most pointed questions. Asked why the agency had opted to ignore a recommendation to end a Medicare Advantage quality bonus program the GAO described as unlikely to produce “meaningful results,” Cochran said only the HHS “made a policy decision to continue that demonstration.”
Cochran also sidestepped repeated questions Wednesday about whether the Obama administration has a contingency plan if the Affordable Care Act is overturned by the Supreme Court. “The focus is on implementing current law,” he said, deflecting repeated questions by Rep. Michael Burgess (R-Texas).
Burgess appeared incredulous. “Your authority to pay providers under Medicare and Medicaid may evaporate on July 1, according to some AP reports. You’ve got to have some contingency,” he said. “This is the equivalent of taking the Fifth on this issue.”
Burgess also pressed Cochran on whether the agency will continue to prosecute fraud in the absence of the ACA. Cochran said the HHS and the Department of Justice will continue working but will lose stepped-up authority included in the healthcare law. “You wouldn’t grind to a halt,” Burgess responded. “Fraud enforcement is not going to go away.”
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