Orshe

Like everybody else, we’ve been busy scrutinizing the details of how the various health-care bills would affect Medicare. As it turns out, though, a whole new special commission — not mentioned in any of the bills — could wind up driving big changes to Medicare, Medicaid and Social Security.

Those three programs are account for “almost all of the projected growth in federal spending” (not counting interest payments on the debt), according to CBO. And they aren’t sustainable; Medicare’s hospital insurance trust fund will be insolvent by 2017, according to current projections.

So Kent Conrad, the Dem who chairs the Senate Budget Committee, is pushing for a special bipartisan commission that would come up with a plan to deal with both tax revenues and spending by the entitlement programs. Congress would have to either approve or reject the plan with a simple up or down vote, with no amendments allowed.

The idea is that the kind of changes needed to keep the entitlements solvent — some combination of benefit cuts and tax increases — are so politically unpalatable that a special commission is needed to give lawmakers political cover.

A similar program has been used to decide which military bases to close. And the health-care bill passed by the Senate Finance committee would create a commission with power over certain Medicare payments, an idea backed by the White House. (The House bill doesn’t include a Medicare commission.)

But the commission Conrad backs would have a broader mandate. The idea has at least some bipartisan support in the Senate, with backing from the Budget Committee’s ranking Republican, Judd Nelson, as well as Mitch McConnell, the Senate minority leader, Kaiser Health News reports. Conrad held a hearing yesterday to push the idea.

Nancy Pelosi is wary of ceding congressional authority to a special commission, the Hill reports. But Congress will soon have to raise the ceiling on the national debt. And several of the backers of a special budget commission have said they won’t vote to raise the ceiling unless Congress also creates a special commission.

If that fails, Conrad will try to attach the proposal for the commission to other legislation — possibly even the big health-care bill Dem leader Harry Reid is likely to bring to the Senate floor next week, the Hill says.

Photo: Associated Press

More: 
What If a Special Commission Pushes Changes to Medicare?