HHS has sent more regulations over to the White House Office and Management and Budget for review. This week, the final rules on essential health benefits and reinsurance mechanisms appeared on the OMB regulatory dashboard.
For those of you who are new to this program, the OMB is where all regulations go to get their rubber stamp of approval from the President before they are released to the public. It usually takes a few days (occasionally as much as a few weeks or even months) for a regulation to move from the OMB to publication in the Federal Register. A regulation’s release is usually tied to a holiday weekend or any day where it would be inconvenient to read up to several hundred pages of health reform implementation requirements. Then we have 30 or 60 days (90 if we are super-lucky) to come up with a thoughtful formal comment letter on those requirements.
All this repeating ourselves about regulations does remind us of a funny clip we read the other day (and by funny, we obviously mean funny to health policy nerds, not normal people). More than two months ago, Senator Orrin Hatch (R-UT) and nine other GOP senators sent HHS Secretary Kathleen Sebelius, Secretary of the Treasury Timothy Geithner and Labor Secretary Hilda Solis a letter asking why some of the most important and long-anticipated PPACA regulations issued to-date, like the ones on actuarial value and essential health benefits, were held for release until after the Presidential election and were issued with only a 30-day comment period, rather than the normal 60 or even 90 days.
Secretary Sebelius finally wrote back this week and stated that the comment windows had to be short because HHS had solicited public input other times via bulletins and stakeholder meetings. Additionally, a longer comment window would mean a longer stretch of time until a final rule and aren’t you senators the ones who are always pointing out that the final regulations need to come out faster anyway? We found the exchange of letters amusing in and of itself, but what really got us chuckling was when Politico’s daily healthcare tip sheet, The Pulse, published an anonymous email to them from a GOP senate staffer that read “Observers may find it interesting to note: while stakeholders are not guaranteed 60-days to review and comment on major PPACA-related regulations, the secretary allowed herself some 63 days to respond to the common-sense 3-page letter from the Senators.”