Last week was a productive week for Paragon. As I detail below, I had three particularly exciting media and speaking opportunities: The Wall Street Journal ran my op-ed on problems with the Biden administration’s regulatory process, I was interviewed about health issues and the midterm elections alongside former Health and Human Services (HHS) Secretary Kathleen Sebelius, and I participated in a panel on small business health insurance options organized by the Public Private Strategies Initiative (PPSI).
WSJ op-ed: “With the New ObamaCare Rule, Lack of Transparency Isn’t a Glitch”
On October 12, The Wall Street Journal published my op-ed about the illegal and problematic new rule from the Internal Revenue Service (IRS) which will expand Affordable Care Act (ACA) subsidies. The cleverly framed “family glitch” is a feature of the ACA that intentionally limited the availability of subsidies to keep the cost of the legislation down. The White House put political pressure on the IRS to ignore the law and issue an expensive and inflationary rule that will expand subsidies.
In the op-ed, I detail the shameful regulatory process around the rule. The most recent problem: the Office of Information and Regulatory Affairs (OIRA) cancelled two meetings with me and several other legal and policy experts. Meetings to discuss concerns with proposed rules are required under Executive Order 12866, which was signed by President Clinton and affirmed by every president since.
Some excerpts from the op-ed:
OIRA canceled both meetings and unveiled its regulation without our input. Our first meeting was scheduled for Sept. 28, but OIRA called it off, citing a “Zoom failure.” I then learned that it wasn’t immediately rescheduled because of Hurricane Ian, although the storm had no effect on our ability to meet. Eventually OIRA offered Oct. 12 as an alternative date. Yet on Friday the office officially canceled the meeting and concluded its regulatory review process early. OIRA’s conduct flies in the face of good governance and violates longstanding regulatory policy…
Our canceled meetings don’t seem to have been a one-off for the Biden administration. It held no meetings on its new ObamaCare subsidy rule and has shown similar disregard for transparency on other controversial topics. When the Ethics and Public Policy Center was scheduled to meet with OIRA and regulators from the Department of Health and Human Services to discuss a new family-planning rule under Title X, its meeting was also unexpectedly canceled at the last minute. HHS then finalized the rule without holding any outside meetings…
I concluded the piece with a recommendation for Congress:
Congress should get to the bottom of the Biden administration’s shameful regulatory process. As a start, it should ensure that Richard Revesz—the administration’s pick to lead OIRA, whose nomination is currently before the Senate—will commit to a more transparent and open regulatory review process. If he doesn’t, our federal regulatory process will continue to march down a political course without any regard to the law or sound economics.
I was also quoted in Bloomberg in their article on the rule, noting my expectation that there will be litigation challenging the rule.
Health Policy Discussion with Former Obama HHS Secretary Kathleen Sebelius
On October 11, I appeared on Newsy’s “Morning Rush” to discuss health policy and the midterm elections with former HHS Secretary Kathleen Sebelius and Harvard University professor Robert Blendon. Here is the full segment.
I had two opportunities to respond to questions. In one clip, I discussed the health policy agenda for the next Congress—highlighting potential efforts to expand health care choice, competition, and innovation as well as reform public health institutions given the many problems with the government’s COVID-19 response. In another clip, I discussed the moral hazard introduced by Medicaid that discourages people from planning for long-term care. I also discussed bipartisan efforts to expand choice and improve affordability, such as price transparency and over-the-counter hearing aids.
Highlighting Opportunities for Small Employers to Offer Coverage
Also on October 11, I participated in a virtual panel on small business health coverage, sponsored by PPSI. The panel corresponded with a new report published by PPSI, “Small Employers’ Views on the Evolving Healthcare Landscape.” The panel included several other health policy leaders—including Jeanne Lambrew, the Commissioner of Maine’s Department of Health and Human Services, who served as the Deputy Assistant to President Obama for health policy from 2011-2017.
During the panel, I spoke about employers’ and employees’ opportunity to use individual coverage health reimbursement arrangements (ICHRAs)—a coverage option that I helped to implement when I worked at the White House. I also spoke about issues relating to the family glitch “fix” and the enhanced ACA subsidies. Both the fix and the enhanced subsidies will lead to fewer employers offering coverage, particularly small employers that aren’t subject to the employer mandate penalty. I also spoke about the problems with American health insurance subsidies, particularly the poor design and expense of ACA subsidies given our deteriorating fiscal position.
Further Paragon Impact
Finally, Dr. Joel Zinberg, Paragon’s director of Public Health and American Well-being, is out with an important New York Post piece on the California law aimed at censoring physicians who provide “false or misleading” information about COVID-19. Joel argues that this law is likely unconstitutional, but also deeply problematic since much of the government’s COVID-19 advice has changed over time and can itself be wrong or misleading.
The attention to Paragon’s work over the past week demonstrates our leadership role in conducting high quality research and analysis. Our focus is to help policymakers and the public understand how government programs are working—or not working—while developing solutions that reform government programs and empower patients.
All the best,
Paragon Health Institute