Senate Health-Care Bill Would Grant Broad Powers to HHS Secretary

By Adam Brickley | October 27, 2009 | 9:29pm EDT

Health and Human Services Secretary Kathleen Sebelius (Photo by Penny Starr/

( – The Secretary of Health and Human Services (HHS) would be given broad new powers under the health-care reform bill that passed out of the Senate Finance Committee would be broad new powers.

These powers include defining certain healthcare standards, overseeing aspects of the new government-controlled health-care system. One key section even gives the secretary the power to overrule state governments in some cases.

On page 14 of the “Chairman’s Mark” of the bill released by the Finance Committee, if a state chooses to opt out of certain provisions of the bill, “the Secretary must respond no later than 180 days and if the Secretary refuses to grant a waiver, the Secretary must notify the State and Congress about why the waiver was not granted.”
On page 18, the Secretary is empowered to determine whether HHS should aid in the purchase of insurance for children – and what form that assistance could take:
“The Mark provides for the availability of child-only health insurance coverage through the exchange,” it says, “and would direct the Secretary to determine whether alternative means – such as direct subsidies, and refinements to tax credit eligibility determinations, are necessary to provide support for the purchase of such coverage for children.”
On page 22, the secretary is empowered to define the ratings for insurance plans, which would be labeled “bronze,” “silver,” “gold” or “platinum.”
“The Secretary of HHS,” the bill says, “would be required to define and update the categories of covered treatments, items and services within benefit classes no less than annually through a transparent and public process that allows for public input, including a public comment period.”
The Health and Human Services Secretary -- currently Former Gov. Kathleen Sebelius -- would also be given veto power on any plan to set up an insurance exchange covering more than one state.
“States could, through interstate compacts, form regional exchanges,” says page 20, “subject to approval by the Secretary.”
Page 47 lays out a number of duties specifically assigned to the HHS chief, including setting the official definitions of certain terms within the health insurance industry.
According to the chairman’s mark, the secretary must, “Develop standard definitions for common insurance terms including premium, deductible, co-insurance, co-payment, out-of-pocket limit, preferred provider, non-preferred provider, out-of-network co-payments, UCR (usual, customary and reasonable) fees, excluded services, grievance and appeals, and such other terms as the Secretary determines.”
Even the most minute details of health care are left to the Secretary to define, including: “standard definitions for medical terms" -- including hospitalization, hospital outpatient care, emergency room care, physician services, prescription drug coverage, durable medical equipment, home health care, skilled nursing care, rehabilitation services, hospice services, emergency medical transportation, and "such other terms as the Secretary determines.”

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