Do certain provisions in the health care bill violate disclosure requirements?


Earlier this week, Sen. Tom Coburn and a group of Republican senators sent a letter to Majority Leader Harry Reid stating that certain provisions in the health care reform bill violated disclosure requirements created in the Honest Leadership and Open Government Act of 2007. Here’s a snippet of the letter (Full letter):

“It is clear that the Manager’s Amendment, in addition to the underlying bill, includes specific provisions which benefit some states and not others. We therefore ask you, as the sponsor of the Manager’s Amendment and underlying bill, to provide a list of all earmarks and congressional directed spending as required by The Honest Leadership and Open Government Act of 2007.”

This is a bit perplexing for a couple of reasons. First, the letter does not provide a list of the provisions that may be in violation of disclosure requirements. In the past, Coburn has been excellent at naming and providing lists of earmarks and other questionable provisions in bills, so this strikes me as a bit odd. Second, and most important, the provisions that I can only assume that Coburn is referring to would not fall under the disclosure requirements laid out in the 2007 ethics law. The provisions most likely being referred to are the Louisiana Medicaid deal made by Sen. Mary Landrieu and the Nebraska Medicaid deal made by Sen. Ben Nelson. Increases or changes in Medicaid or Medicare spending are not “directed spending items” as defined by the Honest Leadership and Open Government Act and would not be subject to disclosure requirements. Here’s the relevant legislative language:

5 “(a) the term ‘congressionally directed spending item’ means a provision or report language included primarily at the request of a Senator providing, authorizing, or recommending a specific amount of discretionary budget authority, credit authority, or other spending authority for a contract, loan, loan guarantee, grant, loan authority, or other expenditure with or to an entity, or targeted to a specific State, locality or Congressional district, other than through a statutory or administrative formula-driven or competitive process

Emphasis added. Medicaid and Medicare funding are statutory and administrative formula-driven processes and thus the disclosure requirement does not apply.

Now there could very well be other items in the Senate manager’s amendment to the health care bill that would be subject to these disclosure requirements. I don’t know. It would be useful to see Coburn’s list of “over a half dozen” such provisions to gauge whether they should be subject to the relevant disclosure requirements. Furthermore, if Coburn believes that the requirements under the Honest Leadership and Open Government Act do not go far enough in requiring the disclosure of spending targeted towards the interests of particular members it would be interesting and useful to see statutory or rules changes that he thinks are appropriate. That’s a conversation I’d like to have.