House GOP adopts Bernie Sanders’ plan to extend Obamacare’s mandatory spending.

Examining the Shady Budgetary Gimmicks in Congress

If one wants a microcosm of how ‌our nation accumulated nearly $33 trillion of debt, one⁤ could do worse than to examine a bill House Republican leaders might try to ​pass in ⁤the coming weeks. The shady budgetary gimmicks included in the legislation show⁣ how desperate Congress — ‌meaning members of both parties,⁤ including the conservatives — is‍ to spend more money it doesn’t have.

‘Must-Pass’ Legislation

Many‍ people in health care‌ circles consider the legislation, originally called the PATIENT Act, ‌a “must-pass” measure. ⁤That title comes because funding for ​community health​ centers, which the bill extends, ⁢expires in ​a few weeks at‍ the end of the⁣ fiscal year (Sept. 30).

Extending Obamacare, Not Repealing It

Here’s another dirty little secret about the PATIENT Act. The mandatory community health center funding that the ‍bill would extend originally comes from Section 10503 of Obamacare. Since Sen. Bernie Sanders, I-Vt., requested five years of mandatory funding for community health centers in exchange for ​his vote on Obamacare,⁤ Republicans have consistently ‌extended ⁣the mandatory spending, rather than allowing the health center funding to transition back to the regular⁢ appropriations​ process.

10‍ Years of‌ Savings, Two Years of Spending

The Congressional Budget Office score of the PATIENT Act passed by the Energy and Commerce Committee in May shows the ⁤structural flaws with the legislation. Extending ‍the community health center spending and delaying the DSH reductions will cost about $15 billion over a decade. ​The ⁣CBO score says the bill is paid for —​ but with a catch big enough to drive a Mack truck through.

Transparency Requirements a⁢ Double-Edged Sword

Some conservative‌ analysts might laud other elements of the PATIENT Act. Provisions to promote transparency of health care prices for hospitals and insurers and to reveal more ‍information about the conduct of pharmaceutical benefit managers could indeed ​have⁢ a salutary effect on the marketplace⁣ over time.

Never-Ending Spending Cycle

The transparency provisions⁢ ultimately⁢ amount​ to fancy window dressing — the proverbial lipstick on the pig. The main driver of this legislation — the thing that‌ makes it “must-pass” — comes from its spending: the community health center funding and the waiver of‍ the⁤ DSH reductions.