Even More Details

I was reading through more of the Democratic health bill when I came upon a lengthy section that seems to limit whether a future Congress could even change some parts of this health overhaul.

On page 1000, the bill starts outlining the "Independent Medicare Advisory Board" which would make decisions on Medicare spending, something backers hope can help restrain the growth of the program in the future.

If you start looking at that section, it is nothing interesting, setting up the board, allowing for certain reports, all an effort limit Medicare spending.

But then you get to page 1017, and "Congressional Consideration" of any plans set out by the Medicare board, which basically sets out exactly how Congress has to deal with a recommendation from the board.

The idea is sort of like the military base closing commission of years past - this Medicare panel would agree on rates and payments, and then Congress would approve it with one up or down vote.

This bill spells out - in very exact detail - how such a plan must be considered by committees and the full House and Senate.

In fact, several provisions would actually change the rules of those bodies, in order to deal with such a legislative proposal.

For example: "It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, or amendment," that changes the board's recommendations.

And don't try changing the law on how to deal with the Medicare board either:

"It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection."

In other words, no law is allowed - at any point in the future - to change how this board is setup.

I would like to see that one get hung up in a court, eh?

The bill also changes the rules of both houses on a vote to "appeal the ruling of the chair", where instead of a simple majority, a three-fifths majority would be needed.

As for consideration of the Medicare board's plans, this bill sets out time limits in the Senate - 1 hour on any amendment, 30 minutes on any debatable motions, and does not allow any amendments that are not germane to the provisions of the plan.

And how about this gem:  "It is not in order to consider an amendment that would cause the bill to result in a net reduction in total Medicare program spending in the implementation year that is less than the applicable savings target established under subsection (c)(7)(B) for such implementation year.

In other words, the Congress can't cut Medicare spending by more than the board suggests.  That item can only be waived by a three-fifths vote of the House and Senate.

The Senate would be allowed to consider such a plan for 30 hours, with no filibuster allowed.  This is similar to the rules for consideration of a budget resolution, which sets the framework on the federal budget.