Nancy Pelosi famously said that "we have to pass the bill so you can find out what's in it." Now, as Scott Gottlieb points out, we find that even that isn't enough. Congress left the most important law-writing to the unelected bureaucrats at the Department of Health and Human Services. The result does not look promising:
The 3,000-odd pages of legislation left most of the really important (and controversial) policy decisions to the regulations that government agencies were told to issue once the bill passed. Now that those regs are starting to take shape, it's clear that the Obama team is using its new power to exert tight control over the payment and delivery of all formerly "private" health insurance.
The ObamaCare law references the Secretary of Health and Human Services almost 2,200 times and uses the phrase "the secretary shall" more than 725. Each reference requires HHS to set new rules on medical care, giving control to an existing federal office or one of 160 new agencies that the bill created. . . .
The draft regs envision more than half of all policies having to change within three years -- an unmistakable break with President's Obama's oft-repeated promise, "If people like their insurance, they will be able to keep it."
Yet that may be the least of the broken promises.
Ultimately, these rules force consumers to buy one of just four health policies -- which vary mostly only by trading off higher co-payments for lower premiums, while offering essentially the same actual benefits. In arguing for passage of the law, ObamaCare's defenders claimed the rules were aimed at health plans sold in the "exchanges." Oops: Now [HHS Secretary] Sebelius is applying them to employer plans. Eventually, this would force all but the very wealthiest Americans into a single government-designed insurance scheme.
This just serves to reinforce the point that far from being an outlier, an extreme example of the legislative process, Obamacare is typical of what passes for the rule of law today. Unread bills were lamented by Senator Moynihan over twenty years ago. The agencies making their judgments the meaning of the legislation was seen in the 1964 Civil Rights Act (what Rand Paul should really have complained about) and major legislation since then. Sometimes, as in the Civil Rights Act, the implementation actually contradicted the plain meaning of the law, resulting in busing, quotas, and other race-based policies that violated the principle of color-blindness.
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