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Even with the Medicare hospital trust fund projected to go bust in a few years, slowing the rise in Medicare costs is a political minefield for Congress. One idea that’s gained favor to give lawmakers some political cover is an independent, bipartisan commission that would make recommendations that Congress could approve or reject en masse, without amendments.

Although the idea has been kicked around in the health-care debate, Nancy Pelosi has opposed the idea in the House, and Harry Reid’s Senate bill would create a commission with an authority that’s more limited than earlier proposals suggested.

But maybe a commission will come from outside the health-care debate. As we noted earlier this month, Senate Budget Committee leaders from both parties support creating a commission to take on the financial problems in both Medicare and Social Security. Top White House officials met yesterday with the Budget Committee chairman to discuss the commission idea, and the administration is likely to make its own recommendation for a panel, the WSJ reports this morning.

Congress will soon have to act to raise the ceiling on federal debt, and more than a dozen senators (Democratic, Republican and independent) have said they want to see some action on a special commission before they vote to increase the debt, the WSJ notes.

If such a commission were created, it could be far more powerful than the board described in the Senate health-care bill. (The description of the “Independent Medicare Advisory Board” starts on page 1,000 of the bill.)

As David Leonhardt notes in his New York Times column today, the Senate bill would create a commission without much authority to slow rising costs in the long-term.

The commission would not be allowed to change Medicare eligibility or benefits, and its ability to change payment rates would be limited. Still, a CBO analysis estimated that the commission as described in the bill would reduce spending by $23 billion through 2019.

But beginning in 2020, Leonhardt notes, the commission would only intervene to reduce spending if costs for each Medicare beneficiary rose faster than non-Medicare health spending — which may not be enough to keep Medicare solvent in the absence of significant tax increases.

Photo: Associated Press

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Could an Independent Commission Save Medicare?