Speaker Boehner and Leader McConnell wrote to the President, saying they “respectfully decline” to make recommendations to the President for appointments to the Independent Payment Advisory Board (IPAB) under Obamacare.

The Congressional Research Service (CRS) already confirmed in a memo to Dr. Coburn that the President could recess appoint a functioning majority of IPAB nominees. Dr. Coburn’s summary of that is here.  (Note that this CRS analysis predates more recent court action related to the recess appointments at the National Labor Relations Board.)  

CRS confirmed in a memo to Dr. Coburn what many had feared: under section 3403(d) of PPACA, if the relevant spending threshold is met but IPAB fails to make a recommendation, the Secretary of HHS must make the recommendation, and the Secretary’s recommendation contain the same fast-track procedures that effectively circumvent Congress.

Here’s what CRS said:

“This memorandum responds to your request to CRS for clarification of what would happen under the terms of the Patient Protection and Affordable Care Act (ACA) in the event that the Independent Payment Advisory Board (IPAB) established by that Act failed to submit a legislative proposal to Congress for its consideration as required in years in which specific fiscal conditions are met….In short, should the IPAB fail to submit a package of recommendations in a required submission year, the Secretary is obligated by law to do so. In either event, such legislation would be governed by the ‘fast track’ procedures established by the Act.” (emphasis added)

This means that even if President Obama does not appoint IPAB nominees, Secretary Sebelius by default under the law effectively becomes an IPAB-of-One.  That’s likely one reason former HHS Secretary Mike Leavitt said, Obamacare “puts more power than is prudent in the hands of one person.” 

See the complete memo here.

(WASHINGTON, D.C.) – Today, U.S. Senators Tom Coburn (R-OK) and Richard Burr (R-NC) introduced S. 963, the Preventing an Unrealistic Future Medicaid Augmentation Plans (FMAP) Act of 2013, a bill that will repeal the Affordable Care Act’s enhanced Federal Medical Assistance Percentage (FMAP), or Medicaid FMAP, to prevent the federal government from unfairly committing taxpayer money to incentivize the expansion of state Medicaid programs.  Under this bill, States would still be allowed to expand their Medicaid program, but would do so without the commitment of enhanced federal tax dollars.  

“Since the Supreme Court’s decision last year that the Patient Protection and Affordable Care Act’s mandatory Medicaid expansion was unconstitutional, some states have been trying to figure out whether or not to optionally expand their Medicaid programs,” Dr. Coburn said. “This bill sends a basic message to governors and state legislatures considering expansion:  don’t count on the enhanced federal funding for Medicaid expansions, because Congress has overpromised what it cannot deliver. Realistically, the funding will not be there and the check will bounce.” 

“With federal debt soon to surpass $17 trillion, Congress should be taking steps to curb spending, not making empty promises about future Medicaid funding. Earlier this week, the Congressional Budget said Medicaid spending, if unaltered, would total more than $4.3 trillion over the coming decade, with an average cost increase each year of eight percent.  In the next 10 years, our health care entitlements, along with Social Security, will total more than $3 trillion, each year.” 

“This trajectory is mathematically unsustainable over the long run, so future Congresses will be forced to reduce Medicaid spending, one way or another. In view of the math, it is disingenuous and even deceptive for state or federal politicians to pretend that funding Medicaid on its current path is sustainable.  Pledges to expand ‘coverage’ based on unrealistic budget estimates are empty promises. 

“Today, too many Medicaid patients already experience access problems in Medicaid. The best way to protect lower-income Americans who depend on Medicaid is to not overstretch the program, but to refocus its mission on those who are truly in need.”

“The federal government can barely honor its commitments already on the books, much less fund the expansion of an already broken program,” Sen. Burr said.  “States should have the flexibility to control their own Medicaid programs so they can better address their needs and the health care needs of their patients, but should not be misled by empty promises we all know cannot be met.  While my colleagues and I remain committed to a full repeal of the Affordable Care Act, we should be honest with the American people about what we cannot afford.  This bill takes a critical step toward being honest with the American people about the unsustainable costs of the new health care law by repealing one of the law’s signature pieces—the unrealistic, and unaffordable enhanced FMAP.”

Medicaid spending currently consumes nearly a quarter of every state dollar, passing education as the largest state budgetary commitment.  Today, only a fraction of providers accept Medicaid patients.  As a result, patients have a hard time accessing care.  Expanding this program in its current form will by no means fix this broken program and will only worsen our fiscal situation.  This bill will protect the American taxpayer from paying more for a program that too often fails those who rely on it. 

Supporting documents:

• Coburn-Burr bill to empower states with flexibility and defined budgets.
• Coburn analysis of savings with Medicaid in Back in Black.
• Coburn analysis of problems with original (pre-SCOTUS) Medicaid expansion in PPACA.
• Coburn work on bipartisan solutions to save Medicaid dollars, reduce Medicaid improper payments, enhance program integrity, catch taxcheats, and reduce vulnerability to fraud.
• Coburn applauding OK Gov. Fallin’s decision not to expand Medicaid after he warned about problems with expansion, including state costs.
• Top ten reasons Medicaid need to be reformed, not expanded.

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WASHINGTON – Today, Senate Homeland Security and Governmental Affairs Committee Chairman Tom Carper (D-Del.) and Ranking Member Tom Coburn (R-Okla.) highlighted a report from the Government Accountability Office (GAO) titled, “Data Center Consolidation: Strengthened Oversight Needed to Achieve Cost Savings Goal”, that reviews progress made in the Federal Data Center Consolidation Initiative. The initiative, spearheaded by the Office of Management and Budget (OMB), seeks to promote the use of “green IT” to reduce power consumption of government data centers, reduce the cost of data center hardware, increase overall information technology (IT) security and shift IT investments to more efficient computing platforms and technologies. OMB has identified two major goals for the initiative: to close 40 percent of the federal data centers and to achieve $3 billion of savings by the end of 2015. 

The report found that federal agencies have made progress toward the initiative’s first goal of closing 40 percent, or 1,235 of the 3,133 total federal data centers by 2015, but more must be done to achieve the initiative’s goal of saving taxpayer money. By the end of December 2012, agencies had consolidated 420 data centers and have plans to close an additional 548 by December 2015. GAO could not, however, determine how much progress agencies have made toward meeting the initiative’s second goal of $3 billion in cost savings by the end of 2015. OMB, the agency responsible for tracking progress made toward the initiative’s goals, has not yet determined a consistent and repeatable method of tracking cost savings throughout agencies. This makes it uncertain whether it is possible to achieve $3 billion in savings by the end of 2015. 

“The American people deserve a more efficient and effective government, particularly given the serious deficit and debt problems we face” said Chairman Carper. “Unnecessary data centers have been bleeding energy and money throughout the federal government and are a prime example of inefficient IT spending. Since taking office, President Obama and his team have taken important and innovative steps to trim the federal government's IT portfolio, including costly data centers. Today’s GAO report shows that the administration continues to make significant progress toward meeting its goals of consolidating 1,235 data centers by the end of 2015 and savings taxpayers money. The second step to closing these data centers, though, is tracking the savings generated and putting that money to good use. As the saying goes, you can’t manage what you can’t measure. This means it is critical that the Office of Management and Budget and agencies continue to improve their process for tracking and measuring progress on this initiative. Without accurate tracking and reporting of performance measures, we run the risk of not achieving the full potential savings. Those of us in Congress will be paying attention to how closely agencies comply and stick to their consolidation plans. I look forward to working with OMB and the agencies to ensure that this important program reaches its full potential.”

“The Office of Management and Budget was right in 2010 to establish an initiative to consolidate duplicative data centers, but today’s GAO report shows that progress has not been satisfactory and raises significant concerns,” Dr. Coburn said. “Namely, OMB has failed to identify and track cost savings.  Without this important metric OMB has no way to compare their progress to their original goal, which was to find $3 billion in savings.  I encourage OMB to quickly institute the procedural reforms the GAO has outlined to improve their implementation effort and to ensure responsibilities are being fully executed.  These include making changes to reporting requirements, bettering coordination between various administrative actors, and enhancing oversight of agency consolidations.  I look forward to working with the new leadership at OMB to ensure the consolidation effort is successful by improving OMB’s practices and holding agencies accountable.“

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Dr. Coburn filed the following amendments to S. 601, the Water Resources Development Act:

Amendment 804 - To require agencies to report annually on owned, purchased and lost guns and ammunition.  Additional information here.  

Amendment 805 - To protect the right of individuals to bear arms, in accordance with state laws,  at water resources development projects administered by the Secretary of the Army.  Additional information here. 

Failed 56-43.

Amendment 814 – To reduce federal subsidies for ongoing beach renourishment.  Cosponsored by Sens. Flake and McCain.  Additional information here.  

*Supported by Citizens Against Government Waste* 

*Supported by Taxpayers for Common Sense*

Amendment 815 - To stop federal subsidies for ongoing beach renourishment from being extended to 65 years.  Cosponsored by Sens. Flake and McCain.  Additional information here.

*Supported by Citizens Against Government Waste* 

*Supported by Taxpayers for Common Sense*   

Failed 43-53.

Amendment 816 – To remove restrictions on projects the infrastructure deauthorization commission may consider.  Cosponsored by Sens. McCaskill and McCain.  Additional information here.

*Supported by Citizens Against Government Waste* 

*Supported by Taxpayers for Common Sense*           

Failed 32-61.

Amendment 823 – To ensure environmental infrastructure activities are not exempt from review by the infrastructure deauthorization commission.   Cosponsored by Sen. McCain.  Additional information here.

*Supported by Citizens Against Government Waste* 

Amendment 858 - To provide for the disposition of certain federal land originally purchased for a lake that never materialized located in Texas County, Oklahoma.  Additional information here.  

(WASHINGTON, D.C.) – Today, Senate Homeland Security and Governmental Affairs Ranking Member Tom Coburn, M.D. (R-OK), Chairman Tom Carper (D-DE), Financial and Contracting Oversight Subcommittee Chairwoman Claire McCaskill (D-MO), Senator Susan Collins (R-ME), and House Committee on Oversight and Government Reform Chairman Darrell Issa highlighted a report from the Government Accountability Office (GAO) entitled, Federal Employees’ Compensation Act: Case Examples Illustrate Vulnerabilities that Could Result in Improper Payments of Overlapping Benefits.  The report examines improper and overlapping payments in the Federal Employees Compensation Act (FECA) and Unemployment Insurance programs.  The programs are administered by the Department of Labor’s (DOL) Office of Workers’ Compensation Programs (OWCP) and the Unemployment Insurance program is managed at the state-level. In its report, the GAO outlined steps to lower the risk of improper payments, including actions by the Department of Labor, as well as necessary action by Congress to allow the Department of Labor and state governments to perform more effective oversight and payment controls.                            

“Today’s GAO report demonstrates the need for strong oversight and accountability to protect taxpayers from having to foot the bill for egregious compensation claims from federal employees,” Dr. Coburn said.  “The GAO has identified problems at the Department of Labor including issues with incomplete and outdated medical documentation, poor wage-tracking procedures, and failures in identifying overlap with unemployment insurance.  With $2.1 billion in wage-loss compensation disbursed in fiscal year 2012, the Department of Labor’s priority should be ensuring American families are not forking over their hard-earned tax dollars to pay for improper and incomplete claims.  I look forward to working with the Administration and Congress to make the reforms necessary to FECA to ensure the federal employees’ compensation is not compromised by fraud and abuse.”        

“Federal workers provide essential services to the American people – protecting our nation, caring for our veterans, maintaining the safety of our food and water, and much more.  In many federal jobs, hardworking officers and employees put their own safety and health at risk in service to the public.  When injuries do occur, it is essential that we provide the resources necessary to support and rehabilitate those who have been hurt on the job and help them get back to work as soon as possible,” said Chairman Carper.  “This GAO report gives us a very important roadmap to help prevent erroneous payments and to strengthen agencies’ ability to keep the few bad actors from draining scarce funds.  Moving forward, Congress, federal agencies, and state governments must work together to ensure that the proper reforms are in place and are being followed.  I look forward to working with my colleagues to review GAO’s recommendations further and make improvements to this vital program.” 

“Families and businesses in every corner of the country are dealing with the effects of shrinking federal budgets, so it’s disturbing to see this amount of improper and overlapping payments of Americans’ tax dollars,” said McCaskill, Chairman of the Senate Subcommittee on Financial & Contracting Oversight. “If we’re serious about squeezing every penny of savings possible out of our agencies, then we can start with the low-hanging fruit of stopping these types of improper payments.” 

“This program, intended as assistance for injured workers to help them recover and return to work, last year had more than 10,000 employees age 70 or older receiving higher payments on workers' comp than they would under the standard retirement program.  More than 400 of these workers are over 90, and six workers are 100 years old or older.  These employees are clearly not coming back to work,” said Senator Collins.  “This report has identified significant problems with incomplete and outdated medical documentation, poor wage-tracking procedures, and failures in identifying overlap with unemployment insurance that I have proposed reforms to fix.  I look forward to working with Senator Coburn to make sure that the Department of Labor is not paying erroneous compensation claims and that the system is fair for all federal workers.”

“GAO identified a number of cases where federal workers underreported outside income and received unemployment insurance and FECA payments in excess of their federal salary, Chairman Issa said.  “Reducing fraud and improper payments within the program will help ensure FECA is available for future generations of civil servants injured in the performance of duty.”      

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WASHINGTON – Today, Senate Homeland Security and Governmental Affairs Committee Chairman Tom Carper (D-Del.), Ranking Member Tom Coburn (R-Okla.) and Financial and Contracting Oversight Subcommittee Chairwoman Claire McCaskill (D-MO) highlighted a report from the Government Accountability Office (GAO) entitled, “Medicaid: Enhancements Needed for Improper Payments Reporting and Related Corrective Action Monitoring.” The report reviews the effectiveness of the Center for Medicare and Medicaid Services’ (CMS) estimating of national improper payment rates for the Medicaid program. GAO found that the accuracy and methodology of the Medicaid improper payments estimate is fundamentally sound and significant improvements have been made since 2010. Despite this overall success GAO identified a few areas that need attention. The report found that state agencies often make Medicaid overpayments when beneficiaries’ eligibility statuses are not reviewed. The GAO report also points out that states and federal agencies can work together to tailor corrective action plans to improve oversight to limit this waste.

“Today’s GAO report is a promising sign that legislation Congress has passed over the past few years is making a real difference in identifying and eliminating waste in the federal government," said Chairman Carper. “The Centers for Medicare and Medicaid Services has accomplished a key goal, and now has a system in place to identify improper payments, which is an important first step toward stopping these expensive errors. Despite these great strides, we still have work to do in curbing waste, improving transparency, and making agencies and agency leadership more accountable for better protecting the resources we entrust to them. CMS should continue to work with its state partners to limit improper payments and implement corrective action plans to improve oversight. This can be accomplished by working with states to establish a comprehensive, nationwide system that double checks eligibility, thereby preventing a large number of improper payments. Finding ways to save taxpayer dollars is an all hands on deck effort that will require federal, state and local governments to work together toward the same goal. Today’s GAO report helps draw a roadmap toward that goal.”

“In fiscal year 2011, Medicaid had the second-highest estimated improper payments of any federal program at $21.9 billion. GAO’s work outlined steps necessary to make the error rate more timely and meaningful,” said Ranking Member Coburn. “As they note, capturing an accurate reading currently takes three years-worth of data.  While Congress has a responsibility to ensure the soundness of the program, bureaucrats in Washington can’t micromanage Medicaid and fix all of its problems. Improper payments are best reduced when accountability is strong, incentives are aligned, and states are leaders. I look forward to working with my colleagues to put Medicaid on a more sustainable path.”

“We’ve got to continue squeezing every possible penny of efficiency out of these programs,” said Senator Claire McCaskill, Chairman of the Subcommittee on Financial & Contracting Oversight. “Overpayments waste taxpayer dollars and contribute to our national debt—it’s great news we’re making progress on this issue and I look forward to continuing to prioritize it.”

In 2010, Congress passed and President Obama signed into law The Improper Payments Elimination and Recovery Act, which created a set of important tools to address government waste, including:  requiring agencies to produce corrective action plans with targets to reduce overpayment errors; mandating all agencies that spend more than $1 million perform recovery audits on all their programs to actually recoup the overpayments; and penalizing agencies that fail to comply with current accounting and recovery laws. Following the 2010 landmark legislation, Congress passed and the President signed into law the Improper Payments Elimination and Recovery Improvement Act of 2012 that builds on the 2010 law by taking additional steps to identify and prevent improper payments made by federal agencies. In 2012, CMS estimated that the national improper payment error rate for the Medicaid program was 7.1 percent, or $19.2 billion. By identifying areas of improper payments such as these, and working to recoup overpayments, CMS is able to generate billions of dollars worth of taxpayer savings each year.

WASHINGTON – Today, Senate Homeland Security and Governmental Affairs Committee Chairman Tom Carper (D-Del.) and Ranking Member Tom Coburn (R-Okla.) released the following statement regarding the Committee’s ongoing oversight of the April 15, 2013, bombings at the Boston Marathon. Chairman Carper and Ranking Member Coburn continue to work closely together to gather and review information regarding the events leading up to and immediately following the Boston bombings. This process is ongoing and will help determine what additional steps the Committee will take with regard to the Boston Marathon bombings.

“Our thoughts and prayers continue to be with those in Boston and around the world who have been affected by this tragedy.  As part of the Committee’s responsibility to oversee the Department of Homeland Security and interagency coordination in protecting the United States from terrorist attacks, we need to understand more fully how the federal government carried out its responsibilities before and after the Boston bombings. To this end, we have already requested additional information regarding events prior to the bombing and the federal government’s response to the attack from the Department of Homeland Security.

“Once the Committee has had an opportunity to perform a thorough analysis of the information requested, we will make a final determination on the appropriate next steps in our ongoing oversight but we fully expect the Committee to hold hearings on this terrorist attack in order to better understand what the federal government did well and what lessons can be learned from the efforts to prevent and respond to this attack. It is critical that we conduct a proper examination of the actions of the federal government, including the Department of Homeland Security, and its interactions with state and local government partners, so that we as a nation are better able to anticipate, prevent, or if necessary respond to, the next terrorist threat.”

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(WASHINGTON, D.C.) – Today, U.S. Sens. Tom Coburn, M.D. (R-OK) and Mark Udall (D-CO) introduced legislation to change the Senate rules to ensure lawmakers have necessary information available to identify all similar existing federal programs before creating new initiatives.  This legislation would require an analysis be completed by the Congressional Research Service (CRS) to identify if a new bill creates any federal program, office, or initiative that would duplicate or overlap an existing federal entity.  This reform would require CRS to issue a “duplication score,” which would explain if the considered legislation creates new programs duplicative of existing programs.

Earlier this month, the Government Accountability Office (GAO) issued its third annual duplication report identifying potential savings of $95 billion among 17 areas of government duplication and 14 areas of potential cost savings.  Despite three years of uncovering duplicative programs, the GAO has yet to identify all overlapping programs in the federal government.  All the while, Congress continues to reduce its oversight duties and instead continues to introduce policies and legislation that add more to federal government duplication and overlap.  With a national debt soon to top $17 trillion, Congress must use all tools available to make smart policy decisions that ensure taxpayer funds are not spent on creating new programs that replicate existing programs.

“Across America, families continue to make hard choices to make ends meet.  We need to be doing the same in Washington.  One easy choice for members of Congress is to avoid spending money on programs that duplicate existing programs.  Over the past three years, the GAO has found nearly $300 billion in overlap in their annual duplication reports.  If individual members of the Senate fail to do the research to determine if their proposals are duplicative, this bill will ensure they receive that information.  No family would handle their finances in such a haphazard way, and I’m pleased many of my colleagues on both sides of the aisle agree,” said Dr. Coburn

“All too often, Congress focuses on creating new programs and regulations instead of updating existing programs or abolishing those that have outlived their purpose,”  Udall said.  “This bipartisan, common-sense bill will help eliminate duplicative programs and ensure that lawmakers formally analyze possible duplication when they draft a bill or resolution.  The process this bill creates will force the federal government to be more efficient and give the taxpayers a better return on their dollar.”

Since release of GAO’s first report on duplication, the Senate has twice rejected bipartisan legislation aimed at preventing future duplication.

First, on June 29, 2011, the Senate rejected identical legislation offered to S. Res. 116.  The vote result was 63 - 34 (Yea –Nay), however, the measure failed to achieve the two-thirds vote threshold needed to pass.

On February 2, 2012, the Senate voted on the measure a second time.  The vote result was 60-39 (Yea-Nay) but it again failed to garner the votes necessary for passage.

Key GAO findings and examples of duplication, mismanagement, and waste from the 2013 report include:

• 679 renewable energy initiatives at 23 federal agencies and their 130 sub-agencies cost taxpayers $15 billion in FY 2010.

• 76 programs to prevent or treat drug abuse are spread across 15 agencies, costing $4.5 billion in FY 2012.

• Three federal offices are involved in overseeing catfish inspections.

• 159 contracting organizations in 10 different Defense Department components provide defense foreign language support. GAO estimates $50 to $200 million in potential savings by eliminating this duplication.

• The Broadcasting Board of Governors (BBG) offers 69 different language services. GAO found 23 instances of overlap involving 43 of these services, accounting for $149 million, or nearly 20 percent, of the BBG’s FY 2011 annual appropriations.

• 21 programs, including eight tax expenditures, are in place to help students save for, pay, and repay the cost of higher education, annually costing $45 billion, $104 billion in financial loans, and $25 billion in lost revenue from tax spending. 

Additional information available here. 

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WASHINGTON, D.C. – Today, U.S. Senators Richard Burr (R-NC), Tom Coburn (R-OK), and John Thune (R-SD)  introduced the Public Employee Pension Transparency Act, legislation that will enhance transparency for state and local pensions and establish a clear federal prohibition on any future public pension bailouts by the federal government.

Congressman Devin Nunes (CA-21), Budget Committee Chairman Paul Ryan (WI-1), and Government Reform and Oversight Chairman Darrell Issa (CA-49), will introduce companion legislation in the House this week.

“For too long, taxpayers and government employees have been denied information about how badly government worker pension plans are underfunded.  My bill would simply shed some light on these enormous liabilities. This information is only for the purpose of public disclosure; it does not tread on the rights of states and local governments to fund and control their own pension plans,” said Senator Burr. “My bill also prevents a federal bailout of state and local government pension plans, empowering local governments to make the reforms needed to ensure problems cannot be dumped on taxpayers down the road.”

“This bill brings much needed transparency to the finances of public employee pension funds.  Taxpayers and government employees currently do not have the tools necessary to identify mismanaged pension funds. This bill would change that by incentivizing states and local governments to submit reports detailing financial costs and solvency of public employee pension plans,” Dr. Coburn said.  “This legislation also ensures taxpayers will not be required to bailout mismanaged pension funds.  Shielding taxpayers from funding bailouts and providing the tools necessary for transparent reporting are two ways to protect the health of pension funds that will benefit both taxpayers and public employees alike.”

“State and local government pension liabilities across the country are currently being understated and taxpayers have a right to know the true dimensions of this looming problem,” said Senator Thune. “It is crucial that states provide more transparency and accountability regarding their pension liabilities and take necessary steps to get their balance sheets in order. While my state of South Dakota has a well-run pension plan that is not facing insolvency issues, there are a number of states that will exhaust their pension funding by 2020. Taxpayers should not be left on the hook for the unsustainable promises made by state and local governments. I hope my colleagues will join us in supporting this common-sense legislation to increase government transparency.” 

The Public Employee Pension Transparency Act establishes new transparency rules, allowing plans to report their existing financial data but also requiring them to report their methods and assumptions. Public employee pension plans will also have to report their liabilities using a uniform accounting standard that provides realistic rates of return and ties assets to more reasonable fair market valuations.

The bill also specifically states that the federal government will not assume responsibility for any current or future shortfall in a state or local authority’s pension plan.  This is a clear policy statement that will help state and local governments address their very real pension problems.  No longer can proponents of the status quo claim that there will be an endless source of contributions from taxpayers to keep plans running no matter how badly managed or underfunded.  States will now have the moral standing to bring all stakeholders together to solve their problems.  Taxpayers are stakeholders and now they will truly know what they are on the hook for in the context of those discussions.

Independent studies demonstrate that public employee pensions had approximately $1.94 trillion set aside to pay retirement benefits promised to government workers as of 2008. However, these pensions have liabilities of $5.17 trillion, which means that they are underfunded by $3.23 trillion. Ten states are projected to run out of pension funds by 2020, and the vast majority of states will have exhausted their pension funds by 2030.

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The Hill

When Washington finally deals with our long-term fiscal challenges — either by choice or crisis — there will be no better place to begin than with the primary drivers of our debt and deficits: unsustainable entitlement spending, particularly in the area of healthcare.

 Unless Congress intervenes, Medicare could be insolvent as soon 2017. That means Medicare would have no way to pay its bills, endangering benefits for 43 million seniors and 9 million disabled Americans. There is no way grow or tax our way out of this hole. The only way to save Medicare is to change Medicare.

 In the last Congress, we released a bipartisan proposal designed to reduce Medicare outlays by $500 billion to $600 billion over the coming decade by adopting a range of common-sense proposals like charging wealthier seniors more, streamlining Medicare’s cost-sharing and capping out-of-pocket costs so seniors would not be bankrupted by hospital bills.

 One of the most important reforms we endorsed is to adjust the eligibility age for Medicare to reflect gains in life expectancy. This reform alone is estimated to save taxpayers $125 billion over the next decade.

 As most Americans know, the eligibility age for Medicare benefits is currently 65. However, since the creation of the Medicare program in 1965, life expectancy has increased dramatically, from roughly 70 in 1965 to 78 today. Advances in medicine could push life expectancy much further in the near future. The fact that Americans are living longer means the typical Medicare beneficiary spends two to three times as many years on Medicare today as they did in 1965. As a result, program benefits can’t be maintained.

Congress has already placed the retirement age for Social Security at 67. We suggest Congress should do the same by raising the age of eligibility for Medicare by two months every year. This means a 64-year-old would only have to wait an additional two months until they can participate in Medicare. A 63-year-old would wait an additional four months, a 62-year-old would wait an additional six months, and so on. This incremental approach is hardly a radical proposal. What is radical, and irresponsible, is pretending this problem will fix itself.

Moreover, seniors’ need for Medicare coverage at age 65 today is not what it was in 1965. Because people are living longer, healthier lives, there are about 7.7 million workers over age 65 in the workforce — that’s more seniors in the workforce than ever before. In fact, government data shows that approximately a third of seniors ages 65-69 are still in full-time jobs.

Opponents of this common-sense policy have suggested many older Americans have continued to work just so they could keep their health coverage. But the Congressional Budget Office has noted that jobs today “are generally less physically demanding,” suggesting that many seniors “might be capable of working beyond age 65,” and that “many who would do so might have access to employment-based insurance.”

Others have opposed increasing the age of eligibility for Medicare because they say this will increase premiums on individuals under age 65. However, for adults above age 65 who would not have employment-based coverage, federal changes to health insurance next year will make coverage cheaper for seniors, relative to younger adults.

The only foreseeable alternative to common-sense, bipartisan structural reforms like this would be deeper, across-the-board cuts to providers’ reimbursements. But continued deep cuts would harm seniors’ access to care. In fact, last year the Medicare Trustees warned that if current projected cuts materialize, 15 percent of hospitals could close by 2019, causing providers to “withdraw from providing services to Medicare beneficiaries.” 

We expect the Medicare Trustees will issue their annual report soon, but we already know the Medicare program has unfunded liabilities of nearly $37 trillion dollars over the next 75 years. As 10,000 baby boomers age into Medicare each day, the program’s spending will roughly double over the next decade. The need to change Medicare is mathematical, not ideological. While politicians are entitled to their own opinions about how to save Medicare, they aren’t entitled to their own facts or demographics.  

The status quo, not reform, is the greatest threat to seniors who depend on the program. We believe the American people will support these changes if policymakers demonstrate real leadership. A recent poll from the Kaiser Family Foundation found that adjusting Medicare’s eligibility age is supported by two-thirds of seniors and a majority of independents. Kaiser also found people are more likely to support the policy if they understand it will help save Medicare. Adjusting the age of eligibility is a common-sense policy President Obama should endorse and Congress should have the courage to adopt. 

Coburn is the ranking member on the Senate Homeland Security and Government Affairs Committee. Lieberman, an independent, retired earlier this year and is a former chairman of the committee.

Supporting Documents:

Lieberman-Coburn Bipartisan Proposal to Save Medicare

(WASHINGTON, D.C.) – U.S. Senator Tom Coburn, M.D. (R-OK) released the following statement today regarding his amendment #727 to replace the Manchin-Toomey amendment. 

“Under my approach gun owners are treated as part of the solution rather than part of the problem.  Instead of harassing gun owners with new taxes and other burdens, my bill gives law-abiding citizens the tools they need to make sure they aren’t going to transfer a firearm to someone who will be a threat to themselves or others.  For example, under my plan the process of confirming a buyer is not on the NICS list of prohibited buyers – the ‘do not buy list’ – will be as simple as using a smart phone app or printing a boarding pass from your home computer.”

 “The Manchin-Toomey amendment is an unworkable plan that is almost certain to fail even if it passes.  The American people don’t have to settle for failure and more finger-pointing and posturing from career politicians in Washington.  My plan has the best chance of making it to the president’s desk.  If the Senate is serious about solving this problem, this solution is within their reach. 

“Finally, every citizen should be rightfully concerned when Washington legislates in areas where the Constitution explicitly limits government intrusion, and they should hold their representatives accountable when guaranteed rights are infringed upon.  Yet, the fact that my plan won’t be popular with special interest groups on either side, who tend to represent themselves rather than gun owners or the American people, is a sign of its strength. 

“Groups on the left have prioritized record-keeping over safety while groups on the right are helping arm illegal aliens and criminals with their incoherent opposition to any solution that closes gaps in the law.  I’m not intimidated by these groups, and neither should any elected official who is a Constitutional officer of the people.  Unlike professional lobbyists and fundraisers, I have not just talked about Second Amendment rights, I have expanded them.  If special interest groups want to defend a system that arms illegal aliens, pedophiles, spousal abusers, drug dealers, felons, mentally-dangerous persons and others on the ‘do not buy list,’ they are welcome to make that case with their members.”

Key provisions and principles of the Coburn amendment:

• Instead of rerouting all commerce through federally designated person that will charge a $30-$50 fee that creates  a new de facto tax on guns, the Coburn amendment would allow the consumer portal and concealed carry permits to be used for verification, protecting law abiding gun owners’ freedom to easily and safely transfer firearms.
• Respects the 10th amendment by giving states the ability to take primacy of enforcement, implement flexible solutions, and create certain exemptions.
• Reaffirms the federal policy that there will not be a federal firearms registry, and places strict penalties for violation of this policy.
• Improves reporting of mental health records by states to the NICS system.
• Provides proper due process for veterans to prevent them from being unfairly deprived of their Second Amendment Rights.
• Includes a five-year sunset provision that will force Congress to evaluate the effectiveness of the consumer portal.

Supporting documents:

Amendment Text

Section by Section Breakdown

Talking Points

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WASHINGTON, D.C.—Senators John Thune (R-S.D.), Lamar Alexander (R-Tenn.), Pat Roberts (R-Kan.), Richard Burr (R-N.C.), Tom Coburn (R-Okla.), and Mike Enzi (R-Wyo.) today released a white paper, “REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT,” outlining concerns with current federal health information technology (health IT) policy, including increased health care costs, lack of momentum toward interoperability, potential waste and abuse, patient privacy, and long-term sustainability.

The 2009 Obama stimulus bill included the Health Information Technology and Economic and Clinical Health (HITECH) Act which aimed to promote the adoption and meaningful use of health IT. Now, nearly four years after the enactment of the HITECH Act, and after hundreds of pages of regulations implementing the program, we see evidence that the program is at risk of not achieving its goals and that $35 billion in taxpayer money is being spent ineffectively in the process.

Findings from the senators’ white paper include:

• Increased Costs. Despite previous estimates that the HITECH Act would save money due to the efficiencies in storing and sharing records and ordering and coordinating patient care, early reports raise concerns that health IT may have actually accelerated the ordering of unnecessary care as well as increased billing.

• Lack of Clear Path Toward Interoperability. The HITECH Act federal incentive payments are being made to hospitals and physicians without clear evidence that providers can achieve “meaningful use,” or the ability to use the health IT program internally, and without an adequate plan to ensure unaffiliated providers can share information with each other through an interoperable network.

• Lack of Oversight. Reports from the HHS Inspector General (IG), the Government Accountability Office, and stakeholders have revealed that the administration does not have adequate mechanisms in place to prevent waste and fraud in its health IT programs. Taxpayer dollars are being paid to providers who cannot or do not have to demonstrate that the health IT technology is actually used as prescribed, because the administration relies on provider “self-attestation” in many cases to determine eligibility for payments.

• Patient Privacy at Risk. The HHS IG found that the security policies and procedures at the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology – two federal entities which oversee the administration of the health IT program – are lax and may jeopardize sensitive patient data.

• Program Sustainability. It is unclear for providers that have accepted grants and incentive payments how much it will cost to maintain their health IT systems after the initial grant money and incentive payments run out. In 2015, incentive payments in most scenarios cease, and providers face reduced Medicare or Medicaid reimbursements if they do not comply with federal requirements, which may impact small providers that may not have economies of scale to make health IT cost-effective.

The white paper is part of a broader effort to solicit feedback from the administration and foster an ongoing conversation on improving the health IT program with the stakeholder community, including health care providers, technology vendors, and others.

The full health IT white paper is available here. For a copy of the letter requesting stakeholder feedback by May 16, 2013 on the performance of the health IT meaningful use program, click here, and for a copy of the letter and questions from the senators to HHS Secretary Sebelius, click here. Responses to questions in the letter to HHS are requested by June 16, 2013.

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WASHINGTON – Today, Senate Homeland Security and Governmental Affairs Committee Chairman Tom Carper (D-Del.) released the following statement thanking Deputy Secretary of the Department of Homeland Security (DHS) Jane Holl Lute for her service. Earlier this week Deputy Secretary Lute announced her decision to step down from the Department of Homeland Security:

“Jane has been a vital asset in carrying out the Department of Homeland Security’s mission to protect and secure all Americans,” said Chairman Carper. “The skills, expertise and drive she brought to the Department – developed during her thirty years in military and government service – have left us all safer than we were before her arrival at the agency four years ago. Specifically, I want to thank her for her leadership as the chief operating officer of the Department, where she did a remarkable job managing the third-largest federal agency and its 240,000 employees, while making DHS more efficient with scarce taxpayer resources. During her tenure DHS earned a qualified audit opinion on all of its Fiscal Year 2012 financial statements, a first for DHS and in record time for such a large and new federal Department. She was also instrumental in driving the great progress DHS has made in addressing, and significantly narrowing, the operational and management issues that have been designated as "high risk" by the Government Accountability Office.  Finally, Jane played an important role in preparing our country for the 21st Century threat of cyber attacks and in building DHS into a world class cyber organization. We’ll miss her leadership and partnership, but I wish her all the best as she moves into the next chapter of her life and career.”

Dr. Coburn said, “Jane is an outstanding example of a great public servant.  During her time at the Department, she maintained her commitment to solving serious management challenges facing DHS, and I will miss working with her.   No one has asked more tough question of the Department than I have, but I have always appreciated Jane’s candor and intellect.  I hope whoever follows in Jane’s footsteps will have the same commitment to improving the Department by safeguarding American tax dollars and maximizing efforts to protect Americans citizens from harm.”

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Dear Colleague,

As the Senate begins the examination of federal firearms laws and how to protect the Constitution that we have all sworn an oath to, I believe our country deserves a thorough and open debate about this vitally important issue. I want to share with you my proposal for how to help keep firearms out of the hands of the dangerous without using a federally designated 3^rd party and incurring a new tax on guns. 

As a firm believer of the 2^nd Amendment, I support the reasonable expansion of National Instant Criminal Background Check System(NICS) checks into secondary and private markets for the purpose of keeping firearms out of the wrong hands.  Longstanding federal law prohibits convicted felons, those with dangerous mental illness and illegal aliens from purchasing or possessing a firearm.  Yet, unlike retailers, we as private citizens have no tool to know if the purchasers of our weapons in secondary markets (such as gun shows, flea markets, and through internet advertisements) are on the prohibited list.  However, I believe we owe the American people a better plan than a new regime of de facto transfer taxes and burdensome regulations on law abiding gun owners as proposed by Senators Toomey and Manchin. 

Unlike other proposed plans that require a government designated 3rd party to perform transactions in the secondary or private markets, my plan will retain the current freedoms and liberties of law abiding gun owners to participate in gun commerce without a federally  licensed dealer.  Instead of rerouting all commerce through federally designated persons that will charge a $30-$50 and up to $125 fee, creating a new de facto tax on guns, my plan would allow a consumer friendly website or concealed carry permits to be used for verification, allowing law abiding gun owners the freedom to easily and safely transfer firearms. 

I firmly believe that the easier the law is to comply with, the more effective it will be.  Under my plan, if you have a concealed carry permit, you’ve already cleared a NICS check and your life will not be impacted at all.  If you do not, you will need to take an extra 2 minutes to print off a piece of paper or pull up a smart phone app that says you are not on the prohibited list of felons and those with dangerous mental illness.  My plan also provides states the flexibility to come up with their own ideas if they can improve upon the federal law along with giving states the ability to assume primacy of enforcement of compliance.  This is a simple solution that focuses on empowering the individual gun owner to keep firearms out of the hands of the dangerous, not the further expansion of big government.

To my colleagues that say that records are essential to the enforcement of expanding NICS checks, please consider that a record can only be used after a crime has already taken place.  Empowering American citizens to stop prohibited people from buying guns is what will help prevent tragedies.  Requiring record keeping of a legal transaction between two law abiding citizens has no preventative value.   

To my colleagues that say that any reform dealing with gun laws is an infringement on the 2^nd Amendment, then I welcome a debate on your amendments to repeal the 1993 Brady Bill or the provision in the 1968 Gun Control Act that prohibits violent felons and those adjudicated as dangerously mentally ill from purchasing or possessing firearms.  If prohibited people are not going to comply with any law we pass, then why should Congress make an effort to improve the reporting of disqualifying records to NICS.  The more than $1 billion in federal tax dollars spent on creating and maintaining the National Instant Criminal Background Check System is rendered useless when a prohibited purchaser can just as easily procure a firearm from a gun show or an internet marketplace without a NICS check as they can at a gun store. 

My amendment is the only proposal that both reaffirms the constitutional rights and privacy of law abiding citizens while deterring gun violence by enhancing the tools to keep firearms out of the hands of violent criminals and dangerous individuals.

Sincerely,

Tom A. Coburn, M.D.

U.S. Senator

Dr. Coburn’s amendment would require a NICS check or validation permit to be presented for non-FFL transfers, exempting family transfers, estate/will transfers, and all temporary transfers. The requirement can be satisfied in one of four ways:

1) An FFL takes custody of the firearm in order to perform a background check on the transferee as mandated in Schumer original and Manchin-Toomey

2) Presentation of temporary 30 day permit created by running a self-NICS check through a new consumer portal(details below)

3) Usage of a concealed carry permit or any other state issued permit that requires a NICS check to be conducted to obtain

4) Any other alternative that a state comes up with to satisfy the validation requirements for secondary and private market transfers

The amendment also includes a provision that places penalties on ATF agents that abuse records during audits, an IG report on the FBI’s 24 hour destruction rule compliance, a prohibition on records, a prohibition on centralizing records pertaining to gun ownership and a provision that allows states to assume primacy of enforcement of the background check law. 

Consumer Portal

• FBI shall provide a consumer portal through its website, mobile application, or other applicable medium to allow a potential transferee to run a NICS check on his/herself

•A successful background check will provide potential transferee with a temporary 30 day permit that validates he/she is not prohibited from legally purchasing or possessing a firearm

•The temporary permit can be used by the transferee for any private transfers in compliance with state or federal law during the 30 day time window

• The permit will be made available to the transferee as an electronic printable document, via a mobile application or other appropriate means

•The 30 day permit will provide the name, date of expiration of permit, and a unique pin number that can be used to verify activation by transferor

•The consumer portal will be designed with privacy protections so that only a prospective transferee can run his/her own NICS check

•The documentation provided by consumer portal will utilize necessary fraud protections

• A valid 30 day permit provided by the consumer portal that is verified with a valid government-issued photo identification would suit the law’s requirements

• Information provided by prospective transferee to conduct background check through the consumer portal must be destroyed within 24-hours as occurs for FFL conducted background checks

The new law will not go into effect until the consumer portal is up and running, and the law will be nullified if the consumer portal is permanently shut down or defunded.

(WASHINGTON, D.C.) – U.S. Senator Tom Coburn, M.D. (R-OK) released the following statement today regarding a proposal by Senators Joe Manchin (D-WV) and Pat Toomey (R-PA) to expand background checks for gun purchases: 

“The Manchin-Toomey proposal is a good faith but unworkable plan.  The proposal will impose new taxes and unreasonable burdens on law-abiding citizens.  The agreement also prioritizes collecting records over protecting citizens.  As gun control special interest groups admit, the proposal expands the government’s powers to record sales of firearms at the expense of expanding the scope of background checks.  This is the wrong approach.  Preventing sales to dangerous persons, not collecting receipts, will save lives. 

“The proposal also unwisely expands the government’s power to regulate and control the sales of firearms.  A government takeover of gun shows will open more loopholes than it closes.  Instead of paying a gun show tax, gun owners will simply handle those transactions elsewhere.  The Manchin-Toomey proposal, unfortunately, trades a workable way to improve access the NICS database for a system that is not workable and will be extremely difficult to pass Congress and become law.  

“I entered these talks because I believe the American people want a common sense policy that respects their Second Amendment rights and freedoms while giving them the tools they need to make sure they aren’t transferring a firearm to someone who will be a threat to themselves or others.  I intend to offer a substitute amendment based on many previously agreed to bipartisan reforms gun control advocates abandoned.  For instance, I’ll propose a consumer portal that would facilitate access to the NICS database at not just gun shows but for virtually all private sales.  While the Manchin-Toomey proposal is flawed, I commend them for their effort and look forward to the full and open debate the American people deserve.” 

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In a letter to Office of Management and Budget Acting Director Jeffrey Zients, Dr. Coburns calls on the Administration to adhere and acknowledge the Government Accountability Office's recommendations put forth in the non-partisan agency's third installment of annual duplication reports which outlines overlap, fragmentation, and inefficiencies in the federal government.      

"We know exactly where we can save money by eliminating fragmentation, overlap, and duplication, and it is time for the administration and each congressional committee to take action," Dr. Coburn said.

Additional information on the third annual GAO duplication report here.   

Today, the Government Accountability Office (GAO) issued its third annual report exposing unnecessary duplication and overlapping programs throughout the federal government, revealing 17 areas of government duplication and 14 areas of potential cost savings.  Total, this report outlines more than $95 in potential savings from duplicative programs and inefficient practices-more than enough to offset the costs of sequestration.  

Examples from the 2013 Duplication Report

• 679 renewable energy initiatives at 23 federal agencies and their 130 sub-agencies cost taxpayers $15 billion in FY 2010.
• 76 programs to prevent or treat drug abuse are spread across 15 agencies, costing $4.5 billion in FY 2012.
• Three federal offices are involved in overseeing catfish inspections.
• 159 contracting organizations in 10 different Defense Department components provide defense foreign language support. GAO estimates $50 to $200 million in potential savings by eliminating this duplication.
• The Broadcasting Board of Governors (BBG) offers 69 different language services. GAO found 23 instances of overlap involving 43 of these services, accounting for $149 million, or nearly 20 percent, of the BBG’s FY 2011 annual appropriations.
• 21 programs, including eight tax expenditures, are in place to help students save for, pay, and repay the cost of higher education, annually costing $45 billion, $104 billion in financial loans, and $25 billion in lost revenue from tax spending.
• Six programs to employ and train veterans are operated by two government agencies, which spent $1.2 billion in FY 2011 to serve 880,000 participants.  The GAO found, “Despite these efforts, the unemployment rate for veterans who have recently separated from the military is higher than that for other veterans and nonveterans.”
• The Department of Commerce’s National Technical Information Service (NTIS) was established in 1950 and tasked with collecting and distributing certain reports.  Despite the fact that nearly 75 percent of these reports are now available online for free, NTIS continues to charge the public, and even other federal agencies, for these reports.  Even more, 95 percent of those on other websites, were available for free.  Making the government looking even more foolish, GAO explains, “The source that most often had the reports GAO was searching for was another website located at http://www.Google.com.”
• Six separate offices at the Department of Homeland Security are involved in research and development. In one example, “two DHS components awarded five separate contracts that each addressed detection of the same chemical. Moreover, DHS did not have the policies and mechanisms necessary to coordinate or track research and development activities across the department.”

2013 Duplication Report Executive Summary Available Here.

2013 Duplication Report Chart Available Here. 

For the study, GAO compared five types of field-based information sharing entities, including DHS-supported state and local fusion centers, FBI Joint Terrorism Task Forces (JTTFs) and Field Intelligence Groups (FIGs).

Sen. Tom Coburn, Ranking Member of the Homeland Security and Governmental Affairs Committee, said:

“Information-sharing is a vital component of national security, but that is not an excuse to waste taxpayer funds. GAO found a whopping 91 instances of overlap between different criminal and anti-terror information-sharing programs, including state and local fusion centers supported by the Department of Homeland Security. Clearly, government agencies are not coordinating their efforts to secure our nation. I thank GAO for its continuing efforts to highlight waste and duplication in federal programs.”

The full text of the report can be found here.

The Government Accountability Office (GAO) released a report today identifying 82 federal wind-related programs administered by nine different government agencies which cost taxpayers a total of about $2.9 billion in “wind-related obligations” as well as at least $1.1 billion in wind-related tax subsidies in fiscal year 2011.  According to the GAO, the initiatives were “fragmented across agencies, most had overlapping characteristic, and several financing deployment of wind facilities provide some duplicative financial support.”  The complete report is available here. 

Dr. Coburn released the following letter exchanged between New York City Police Department Commissioner Raymond W. Kelly regarding the use of federal Department of Homeland Security grants to pay overtime of local police officers, which would have been restricted under an amendment Dr. Coburn offered to the Continuing Resolution, H.R. 933.  

March 15, 2013, letter from NYPD Commissioner Kelly to Dr. Coburn available here.

March 27, 2013, response from Dr. Coburn to Commissioner Kelly available here.

Amendment information below:

Amendment 69. This amendment would prohibit certain homeland security grants to be spent on conferences, excessive pay, and other unnecessary items. Additional information available here.  The amendment failed to pass 48-51.

Senator Coburn offered amendments to the Senate Budget, S.Con.Res.8.

From the well off to the lower-income, the military, federal employees and the federal bureaucracy, to special interest groups, states, politicians, and Congress itself, when packaged together, the amendments present a balanced approach to deficit reduction that makes everyone part of the solution:

Amendment #401 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 15 financial literacy programs. (Burr) Additional information here. Additional information here.   

Amendment #402 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 160 housing assistance programs. Additional information here.   

Amendment #403 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 253 DOJ grant programs. Additional information here.   

Amendment #404 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 15 unmanned aircraft programs Additional information here.   

Amendment #405 —Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 209 STEM programs. Additional information here.   

Amendment #406 — Amends the employment relief reserve fund to prohibit unemployment payments for individuals with AGI of over $1 million. (Begich) Additional information here.   

Amendment #407 — Reducing Social Security benefits for millionaires.  Create a deficit neutral reserve fund reducing Social Security for individuals with an Adjusted Gross Income of more than $1 million or more to extend the solvency of the Social Security Trust Fund and return the program to its intended purpose as a safety-net for retired Americans. Additional information here.   

Amendment #408 — States pay a fair share for expanding Medicaid.  Create a deficit reduction reserve fund that allows States to expand Medicaid, without the enhanced FMAP that requires the federal government to pay 90 cents of every dollar. (Burr)  Additional information here.

Amendment #409 — Eliminate special hospital payment in Medicare benefiting Massachusetts. Creates a DNRF to sunset the provision in PPACA that increases payments to hospitals in a few States by reducing payments to the majority of States through the Medicare hospital wage index (McCaskill, Baldwin). Additional information here.

Passed 68-31.

Amendment #410 — Creates a deficit reduction reserve fund to allow HSA to count as qualified health plan under the ACA, and allow the employer contribution to HSA to count as offer of credible coverage.  Additional information here.

Amendment #411 — Creates a deficit reduction reserve fund to allow for the furloughing of federal employees with seriously delinquent tax liability. Additional information here.

Amendment #412 — Creates a deficit-reduction reserve fund to end the nonprofit postal discount for state and national political parties.  This amendment would prevent state and national political parties from receiving discounts at a time when the USPS is losing over $40 million a day.  Additional information here.

Passed by a voice vote.

Amendment #413 — No Free Phones. Create a deficit-reduction reserve fund to reform the Lifeline program at the Federal Communications Commission to require minimal payments from subsidized cell phone recipients.  Additional information here.

Amendment #414 — Eliminate special interest tax breaks and loopholes.  Creates a deficit neutral reserve fund to eliminate the special interest tax breaks for the PGA tour, the NFL, NASCAR, Hollywood, Fish Tackle Box, and whaling captains.  Additional information here.

Amendment #415 — Amends the government reform reserve fund to eliminate congressional committees that do not conduct oversight hearings.  Additional information here.

Amendment #416 —End non-defense spending at the Defense Department.  Creates a deficit-neutral reserve fund to remove non-Defense spending from the Defense Department, such as beef jerky and caffeine iPhone apps. Additional information here.

Failed 43 to 56

Amendment #417 — Creates a deficit reduction reserve fund to reduce the income-threshold for the insurance subsidies in ACA. The subsidies currently apply to those with incomes at or below four times the federal poverty level: $60,520 for a family of two. The subsidies should end at 300 percent of the federal poverty level, as they do in Massachusetts, instead of 400 percent. Additional information here.

Amendment #418 — Creates a deficit reduction reserve fund to at least achieve the same level of health care savings in the budget as the President’s Fiscal Commission, or Bowles-Simpson, achieved ($630 billion over ten years). Additional information here.

Amendment #419 —Creates a deficit reduction fund to require prescription opioids subject to abuse to have abuse deterrent formulations. Additional information here.   

Amendment #420 —Amends the government reform reserve fund to require the elimination of overlapping Social Security Disability Insurance Payments and Unemployment Insurance Payments. Additional information here.

Amendment #421 —Amends the reserve fund in the bill relating to assistance for working families to prohibit SNAP funding for junk food purchases. Additional information here.

Amendment #422 —Amends the government reform reserve fund to establish a database for every unclassified report submitted to Congress. Additional information here.

Amendment #423 — Amends the government reform reserve fund to prohibit the sale of federal grants. Additional information here. 

Amendment #486 — Creates a deficit-neutral reserve fund to end the nonprofit postal discount for state and national political parties.  This amendment would prevent state and national political parties from receiving discounts at a time when the USPS is losing over $40 million a day.  Additional information here. 

Amendment #556 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 80 economic development programs.  Additional information here.

Amendment #557 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 53 support for entrepreneurs. programs.

Amendment #558 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 17 FEMA preparedness grant programs.

Amendment #559 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 94 Federal green building programs.  Additional information here.  

Amendment #560 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 14 federal diesel emissions programs. 

Amendment #561 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 50 federal early learning and child care programs. 

Amendment #562 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 18 federal domestic food assistance programs. 

Amendment #563 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 80 federal teacher quality programs. 

Amendment #564 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 30 federal food safety programs. 

Amendment #565 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 18 federal defense language and cultural training programs.

Amendment #566 — Amends the deficit-reduction reserve fund for government reform to require the consolidation of the 21 federal nuclear nonproliferation programs. 

Amendment #567 — Amends the deficit-reduction reserve fund for government reform to require the reduction of the number of generals and flag officers in the Armed Forces.  Additional information here.

Amendment #568 — Amends the deficit-reduction reserve fund for government reform to require increased compliance by the agencies with the USAspending.gov transparency website.  Additional information here.

Amendment #569—Amends the deficit-reduction reserve fund for government reform to require the consolidation of the six federal counter-IED efforts.

Amendment #632—Amends the government reform reserve fund to encourage the use of the Federal Strategic Sourcing Initiative.  Additional information here.

Amendment #633—Amends the government reform reserve fund to establish a database to check for duplicative federal research grants.

Amendment #634—Amends the government reform reserve fund to call for reducing voluntary UN payments. 

Amendment #635—Amends the government reform reserve fund to consolidate the 5 Programs for Reducing Reliance on Petroleum Fuel for Federal Fleet.

Amendment #636—Amends the government reform reserve fund to prohibit NASA funding from going to activities that are outside their goals, such as energy conservation and education.  Additional information here.

Amendment #637—Amends the government reform and efficiency deficit reduction reserve fund to provide for requiring the Department of Defense to auction its unneeded equipment in the United States.

Amendment #638—Amend the government reform and efficiency deficit reduction reserve fund to provide for reducing unnecessary moving costs of enlisted personnel in the United States by lengthening tours at the same base within the continental United States.

Amendment #639—Amends the government reform and efficiency deficit reduction reserve fund to provide for changing a portion of military positions to civilian positions in the areas of logistics and support services.

Amendment #640—Increase the votes needed to waive the spending limits established in the budget. Currently 60 votes. This amendment would require 67 votes to waive point of order for violating spending limits established in this budget. 

Amendment #641—Increase the votes needed to waive the spending limits established in the budget. Currently 60 votes. This amendment would require 67 votes to waive point of order for violating spending limits established in this budget. 

Amendment #642—Amends a reserve fund in the Murray budget that calls for investments in water infrastructure by adding in instructions for them to “prioritize funding for the critical maintenance backlog.”

Amendment #643—Amends the government reform reserve fund to consolidate the 10 programs addressing electronic health records systems for veterans and the military. 

Amendment #644—Amends the government reform reserve fund to prohibit improper payments to deceased individuals, tax cheats, and prisoners.

Amendment #664—Prohibits federal subsidies to slum lords who place children and families in public housing complexes with life threatening conditions or in poor physical condition.

Amendment #665—Prohibits Congress from creating any new commissions or super committees to do its job.

Amendment #666—Prohibits the repayment of federal loans with federal grants.

Amendment #667—Amends the government reform reserve fund to prohibit any agency or program from funding the same project already being funded by another agency or program.

Amendment #668—Amends the government reform reserve fund to prohibit funding for USDA soap operas, USDA Moroccan pottery classes, NASA Martian pizza, NSF robosquirrel, USDA caviar promotion, HUD beauty products for pet, and NASA online rock and roll station.

Amendment #676—Creates a new deficit reduction reserve fund to reduce uncertainty caused by temporary, arbitrary interest rates on federal student loans, and to reduce costs for student borrowers, by basing the fixed interest rate of federally issued student loans on the 10-year Treasury rate plus 3 percentage points for subsidized and unsubsidized loans and 10-year Treasury rate plus 4.1 percentage points for Graduate PLUS and Parent PLUS loans.

Amendment #677—Establishes a deficit-neutral reserve fund preventing any attempts to deprive a citizen of the United States any constitutional rights based on a judgment of a foreign jurisdiction. 

Amendment #678—Would reduce the funding for any congressional committee that does not address the unnecessary duplication within its jurisdiction identified by GAO.  Additional information here.

Amendment #679—Would prohibit the funding or construction of new visitor centers or museums until the White House has been re-opened for public tours.

Amendment #680—Amendment would return the TANF work requirement to the Clinton era by allowing for measures to increase work participation rates under TANF.

Amendment #681—Amends the reserve fund on TANF to allow for an update in the funding formula for TANF. Additional information here.

Amendment #682—Create a new deficit neutral reserve fund to restrict SNAP, TANF, Section 8 and EITC recipients to those at 200% of poverty or below.  Additional information here.

Amendment #683—To prohibit bogus bonuses to contractors for projects that are behind schedule and over budget.

Amendment #684—Amends the housing-related reserve fund to call for consolidation of public housing authorities.  Additional information here.

Amendment #685—Amends a reserve fund in the underlying budget related to providing increased housing benefits to allow for work requirements for Section 8 voucher and public housing recipients.  Additional information here.

Amendment #709—Consolidates several areas of extensive federal duplication as outlined by the Government Accountability Office, including 15 financial literacy programs, 160 housing assistance programs, 15 unmanned aircraft programs, 253 DOJ grant programs, 209 STEM programs, 80 economic development programs, 53 entrepreneurial support programs, 17 FEMA programs, 94 green building programs, 14 diesel emissions programs, 50 early learning and child care programs, 18 domestic food assistance programs, 80 federal teacher quality programs, 18 defense language and cultural training programs, and 21 nuclear nonproliferation programs.  Amendment combines Coburn amendments 401-405 and 556-566.  Additional background here.

Passed 62 to 37

(WASHINGTON, D.C.) – U.S. Senator Tom Coburn, M.D. (R-OK) released the following statement today regarding Senate votes on his amendments to the Continuing Resolution, H.R. 933.   

“I’m disappointed my colleagues prioritized wine train tours and Ukrainian Easter Egg Workshops ahead of tours to the White House and national parks.  This vote shows that some in Washington are intent on essentially declaring war on tourists in order to prove an ideological point about sequestration.  The fact that the Senate rejected cuts the administration itself proposed shows how disconnected Congress is from the American people.  It’s difficult to argue Congress can’t cut spending when, over the last decade, the size of government increased by 89 percent while incomes of Americans dropped by five percent,” Dr. Coburn said of his amendment #93, which was rejected by a vote of 45 to 54. 

“However, I’m pleased the Senate accepted an amendment that restricts funding to low-priority political science grants.  There is no reason to spend $251,000 studying Americans’ attitudes toward the U.S. Senate when citizens can figure that out for free,” Dr. Coburn said.

Specifically, Coburn amendment #65, which was accepted, ensures federal resources are directed towards innovative science by prohibiting the National Science Foundation from funding political science projects, unless the NSF director certifies projects as vital to national security or the economic interests of the U.S.

The Senate also accepted Coburn amendment #70 which would require all Department of Homeland Security-related reports issued to the Senate Appropriations Committee also be given to the Homeland Security and Governmental Affairs Committee. 

The Senate rejected, by a vote of 48 to 51, Coburn amendment #69 which would have prohibited certain homeland security grants to be spent on conferences, excessive pay, and other unnecessary items.

Additional information on amendments here.  

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Dr. Coburn sent the following letter to Treasury Secretary Jack Lew, calling on the department to place priority on American taxpayers to ensure furloughs of critical employees who assist taxpayers are prevented by reducing federal spending for a $187 million tax credit that sends jobs overseas, ensuring the 311,566 federal employees pay their $3.5 billion in unpaid taxes from 2011, and restricting travel schedules and speaking engagements of Treasury staff.

Dr. Coburn sent the following letter to Department of Transportation Secretary Ray Lahood calling on the FAA to cancel upcoming conferences, freeze nonessential hiring and eliminate or reform low-priority programs before cutting costs that could impact flight safety.

Under sequestration, the required savings from the FAA is less than four percent or $600 million of the agency’s $15.9 billion budget.  Meanwhile, the Office of Management and Budget has indicated, despite sequestration, the Department of Transportation will end this year with $34 billion in unobligated funds. 

Dr. Coburn outlined the following immediate actions for FAA to take:

• Cancel upcoming conference and speaking events, which have in the past featured both FAA officials and Hollywood actors.  An upcoming conference, the Second Annual Asia-Pacific Flight Standards Meeting, is currently scheduled for August.
• Freeze hiring of nonessential employees, such as "community planners" and "program assistants," both which FAA has recently advertised paying up to $129,095 and $59,000 respectively. 

"While we value the work of everyone at the FAA, not every employee has duties critical to the immediate mission of the agency," Dr. Coburn said.  "As such, we should give higher priority to those performing essential tasks over others who are not.  Air traffic controllers, safety inspectors, and technicians should certainly receive the highest priority." 

Dr. Coburn also outlined a number of reforms that have been suggested in the President's budget, by the Congressional Budget Office, as well as the National Commission on Fiscal Responsibility and Reform that would save hundreds of millions of dollars:

• Eliminate funding for unnecessary “non-classified basic airports.” Many airports no longer fit the criteria for receiving funding, including 22 privately owned airports. This will save about $41 million.
• Reduce the FAA’s spending on consultants, supplies, and travel by 15 percent.  This will save about $105 million.
• Reduce or eliminate spending on the Small Community Air Service Development Program (SCASDP), 79% which have failed to fully achieve their objectives as reported by the FAA's own inspector general. This reform will save $6 million.
• Reduce Airport Improvement Program (AIP) grants by $926 million, as outlined in the President’s FY2013 budget.  This will save up to $926 million.
• Reduce or eliminate spending on the Essential Air Service (EAS) program, as reccomended by the CBO. This will save $118 million.     

(WASHINGTON, D.C.) – U.S. Sens. Tom Coburn, M.D. (R-OK) and Jeanne Shaheen (D-NH) today introduced a bill that would reduce the federal funding available for the acquisition and leasing of new federal vehicles by 20 percent. The legislation would save approximately $500 million by reducing the amount the federal government can spend on buying and leasing non-essential vehicles according to President Obama’s debt commission, the National Commission on Fiscal Responsibility and Reform, which also supported downsizing the federal vehicle fleet. Sens. Coburn and Shaheen introduced a similar version of the bill in the 112^th Congress.

“In a time of budget constraints, federal agencies should set priorities and make sure all vehicle purchases are absolutely necessary. Using the president’s own debt commission’s recommendation is an easy and commonsense step towards better management of scarce financial resources,” said Dr. Coburn. “This legislation directs agencies to only make necessary purchases, thereby eliminating wasteful, low-priority spending.”

“Simply put, the government’s vehicle budget is out of control and needs to be cut. There’s no reason for some of these government agencies to own fleets of expensive SUVs, and this bill will implement common sense cuts and reforms,” said Senator Jeanne Shaheen. “This is a perfect example of an area where the government can and should be able to get by with less. Now more than ever we need to rally around smart, common sense reforms like this one to rein in our spending.”

According to a 2012 study by the Government Accountability Office, the number of federal vehicles, excluding postal and non-tactical military, increased about seven percent since fiscal year 2005, from 420,000 to 449,000 vehicles.

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Supporting documents: Statement for the Record

Dr. Coburn sent a letter to OMB Tuesday highlighting more than 1,362 duplicative programs accounting for at least $364.5 billion in federal spending every year as identified by the Government Accountability Office.  

"Instead of arbitrarily furloughing personnel who may perform essential duties, OMB should first direct agencies to consolidate overlapping and duplicative programs and eliminate those positions that perform nearly identical duties," Dr. Coburn said.  "During a time of budget cuts, it is irresponsible to pay two or more people to do the same job, while laying off other employees in essential positions performing critical duties."

In a letter to Department of Homeland Security Secretary Janet Napolitano, Dr. Coburn outlines areas of waste within DHS that should be addressed first as sequestration looms.  Examples include a $212 million detection behavior  rogram said to "lack outcome-oriented goals" by the GAO, a $75 million chemical facilities program which has failed to accomplish its goals at a handful of locations, and $5.25 billion in unspent FEMA grant funds.  "By eliminating wasteful, duplicative, ineffective and low-priority programs first, rather than starting with its high-priority missions, DHS can successfully navigate sequestration and continue to perform its vital functions," Dr. Coburn said.    

As the White House voices concerns about the possible impacts of sequestration on government programs for the poor and middle class, food safety and the defense of our nation, the Administration continues to spend on a 100 city cross country tour promoting federal aid and spending.  If the Administration is serious about preventing spending cuts on programs many consider vital, how can they also promise more financial assistance, and more importantly, how can they afford this mammoth cross country tour?     

See letter here.  

(WASHINGTON, D.C.) – U.S. Senator Tom Coburn, M.D. (R-OK) released the following statement after the Senate defeated two critical amendments that would have protected victims of sex crimes.

“When the United States Senate protects wasteful and duplicative spending ahead of victims of sex crimes, the American people have to ask serious questions about the competence of their elected leaders. Across America, victims of rape are being abused not just by their attackers but by a system that was designed to help them recover and find justice,” Dr. Coburn said.

Coburn amendment #15, which was defeated by a vote of 46 to 53, would have more quickly resolved rape cases by reducing unnecessary duplication and overlap within the Department of Justice (DOJ) and the Department of Health and Human Services (HHS). The amendment would have provided at least $600 million to support solving sexual crimes from the savings reached by consolidating and streamlining federal programs.

Coburn amendment #16, which was defeated by a vote of 43 to 57, would have better protected rape victims from HIV/AIDS and other sexually transmitted diseases (STDs) by allowing for the testing of indicted assailants and providing treatment to survivors who are at risk or infected. The Coburn amendment would have increased penalties to states that refused to implement such laws. The amendment was necessary because states were choosing to accept the penalty enacted in the previous version of the Violence Against Women Act rather than implementing the law.

This amendment would have increased the protection of rape victims by 1) increasing the penalty from 5% to 20% to ensure more grantees provide offender testing; 2) expand the testing to all sexually-transmitted diseases (STDs) for which a diagnostic test exists; and 3) require the Justice Department to report annually on grantee compliance with such testing.

Dr. Coburn also voted against the Leahy amendment that sought to increase funding for victims of trafficking without adequately addressing the widespread waste, mismanagement and duplication that already exists in the federal government’s anti-trafficking programs.

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WASHINGTON- House Oversight and Government Reform Committee Chairman Darrell Issa, R-Calif., and Senate Homeland Security and Governmental Affairs Ranking Member Tom Coburn M.D., R-Okla., sent a letter to leaders of both chambers of Congress supporting today’s announcement by the United States Postal Service that in August it would shift from its current delivery schedule to a six-day package, five-day mail delivery schedule. Issa and Coburn are the top Republicans on the respective House and Senate Committees with jurisdiction over USPS.

“This common-sense reform would save the Postal Service more than two billion annually,” wrote Coburn and Issa. “In his recent inaugural address, President Obama spoke about the need to find real solutions to our nation’s problems. Supporting the US Postal Service’s plan to move forward with 5-day mail delivery is one such solution worthy of bipartisan support.”

Since 1984, Congress has annually imposed an over $2 billion unfunded mandate on USPS to deliver six days a week. Coburn and Issa ask House and Senate leaders of both parties to work with them to ensure no such restriction is reintroduced when the FY2013 government funding resolution expires at the end of March.

The letter also notes that “President Obama has repeatedly called for moving to 5-day delivery of mail, most recently in his FY 2013 budget.”

You can read a copy of the letter here.

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Over the past year, many of my constituents have contacted my office asking for more information about the Department of Homeland Security’s plans for purchasing large amounts of ammunition.   Given my position on the Senate Homeland Security and Governmental Affairs Committee, I wrote a letter to Sec. Napolitano on November 13, 2012, asking for more information about DHS’s plans for ammunition purchases. 

On February 3, 2013, the Department of Homeland Security responded to my letter.  In the interest of promoting transparency and a constructive dialogue about this issue, I am posting my letter and their response. 

DHS Response Part 1 Here.

DHS Response Part 2 Here.  

(WASHINGTON, D.C.) – Today, U.S. Senators Tom Coburn, M.D. (R-OK) and Mark Udall (D-CO) will introduce a bill that would prohibit the use of Presidential Election Campaign Funds (PECF) for future political party nominating conventions.

During the 112^th Congress, Dr. Coburn and Sen. Udall introduced similar legislation (S. 3257) to abolish taxpayer money from being used for conventions. The legislation passed with a vote of 95 to 4 in the Senate as an amendment to the Agriculture Reform, Food, and Jobs Act of 2012 (S. 3240). Similarly, the House of Representatives passed H.R. 5912 in the 112^th Congress, a bill approved by a vote of 310-95 to end future federal funding of political conventions. However, neither piece of legislation was signed into law by the end of the 112^th Congress.

“Congress has tough decisions on deck that must be made in order to rein in our unsustainable debt and deficit, and this is one bipartisan step forward in right direction. Taxpayers should not foot the bill for events that are solely parties for polarized partisanship,” Dr. Coburn said. “With this common-sense legislation receiving previous bipartisan support and passage in both houses of Congress, I am hopeful members will act again to ensure the practice of subsidizing extravagant party conventions with taxpayer dollars is ended in the new Congress.”

"Over the past several decades, political party nominating conventions have become lavish and elaborate celebrations devoted to partisanship. At a time when we’re working to trim all unnecessary spending, it is a no-brainer for taxpayers to stop footing part of the bill for these large, expensive events, " Udall said. "The Senate passed this common-sense legislation by a broad bipartisan margin last year and the House of Representatives passed a similar bill, too, last year. This legislation is but one down payment on some of the larger decisions Congress will have to make to show that it is serious about fiscal discipline."

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Supporting documents

• View text of the legislation, here.

• Congressional Research Service report on public funding for Presidential Nominating Conventions.

• Examples of spending by-the-numbers: 2008 Republican National Convention Committee.

• Examples of spending by-the-numbers: 2008 Democratic National Convention Committee.

• Dr. Coburn called for the elimination of taxpayer subsidies for party conventions in his 2011 Wastebook report, citing this report from the Congressional Research Service on federal funding for 2012 Presidential nominating conventions.

• Additional explanation of how the Presidential Election Campaign Fund (PECF) operates.

• Background on other efforts from the Republican Study Caucus (RSC) to eliminate funding for conventions in 2009: here.

The Foreign Assistance Transparency and Accountability Act passed the House 390-0 earlier this month.

The Act directs the Obama administration to develop performance measures and metrics for foreign assistance programs and to report back to Congress in a year on the results. It also requires within two years the establishment of a website for information on foreign assistance.

However, there is already a website (www.foreignassistance.gov) that isn’t populated with information from the State Department or USAID. This bill makes no mention of the existing website which duplicates usaspending.gov mandated by the law that Dr. Coburn and then-Senator Obama sponsored called the Federal Funding Accountability and Transparency Act. This bill effectively requires the President to create a website in two years for something that already exists.

Regarding metrics and performance benchmarks, the bill’s intention is to enhance transparency and accountability within the federal government. However, the bill allows the federal government to develop its own grading system. Since the government has failed at metrics development in the past, this bill would provide little enhanced transparency since it essentially allows the federal government to develop, write, and then grade their own metrics test.

Under former President George W. Bush’s Administration, each program was given the following grades when looking at performance by the Office of Management and Budget (OMB): Effective, Not effective, or Results not demonstrated.

Using this previous standard, several commonsense questions can be raised about any program. For example, a simple set of metrics for foreign assistance would be: If the project is a road project, how many miles of road were built? What was the cost of dollars per mile?  Was it effective - did traffic and trade increase?  If it is a clean water program, how many people received clean water? What was the cost of dollars per gallon?  Was it effective - did disease rates go down? If it is a child literacy program, how many kids learned to read? Was it effective - did literacy rates go up? This is not a complicated process that requires years of study.

Unfortunately, there are no consequences in this legislation for the administration failing to follow existing law. Giving the administration until 2015 to use a website that exists today or to write up a report on metrics without instituting a single one of them is not reform and will harm the cause of transparency and accountability rather than help it.

Two new studies largely confirm the nature of concerns Sens. Thune, Burr, Roberts, and recently raised about the management and outcomes of the Administration’s electronic health record program. In their letter, the Senators asked the Administration four questions, including (1) whether “the use of taxpayer-subsidized electronic health records (EHRs), in some circumstances, actually increase[s] the utilization of diagnostic tests rather than reduce[s] them,” and (2) if “some health care providers received federal subsidies for EHR systems they already had in place prior to the adoption of federal standards and mandates.”

A new study reported in the Journal of the American Medical Association (JAMA) shed additional light on the first concern. The study concluded that “having online access to medical records and clinicians was associated with increased use of clinical services compared with group members who did not have online access.” This largely confirms the Senators concerns that federal health IT policy could lead to increased utilization and costs.

Second, a new report coming out today from the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (attached) offers “an early assessment of CMS’s oversight of the Medicare electronic health record (EHR) incentive program, for which CMS estimates it will pay $6.6 billion in incentive payments between 2011 and 2016.” The OIG found that “CMS faces obstacles to overseeing the Medicare EHR incentive program that leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements.” As the OIG explained, CMS currently “has not implemented strong prepayment safeguards, and its ability to safeguard incentive payments post payment is also limited.”

This largely confirms the Senators concerns that CMS and ONC may not have appropriate safeguards in place to ensure the appropriate use of taxpayer dollars. In fact, the OIG warned that “ONC requirements for EHR reports may contribute to CMS’s oversight obstacles.” Troublingly, CMS did not agree with the OIG’s recommendation that CMS first “obtain and review supporting documentation from selected professionals and hospitals prior to payment to verify the accuracy of their self reported information.”

Given the nature of the concerns, additional Congressional oversight is likely expected.

Dr. Coburn filed the following amendments to S. 3525, the Sportsmen’s Act of 2012.

Coburn amendment #2914 – This amendment would require all veterans who are considered mentally incompetent for purposes of assigning benefit payments, not be considered “adjudicated as a mental defective” unless they have been found by a judicial authority to be a danger to themselves or to others. Additional background, here.

Coburn amendment #2915 - This amendment would prioritize federal funds by directing half of the receipts from land sales through FLTFA towards deficit reduction and half towards fixing crumbling structures and roads on federal lands. Additional background, here.

Coburn amendment #2916 –This amendment would strike the mandate that 75 percent of funds from the Neotropical Migratory Bird Program are expended on projects located outside of the United States. Additional background, here.

Coburn amendment #2917 – This amendment would strike the section codifying the duplicative National Fish Habitat Conservation Fund. Additional background, here.

Coburn amendment #2918 – This amendment would protect the 2nd Amendment rights of individuals on lands managed by the Army Corps of Engineers. Additional background, here.

Thank you for that kind introduction. It’s an honor to be with you tonight as we celebrate the American Spectator’s 45th anniversary. I especially want to thank Bob Tyrrell who has been with the Spectator since the very beginning. Bob, I want thank you and honor you for your commitment to telling the truth, and for reminding us to laugh, which is especially important in times like this.

Like most of you I wish we had a different outcome last week. But it’s important to talk honestly about what happened, and what we can do to get our nation back on track.

This election, I believe, is a seminal moment in history. We may have passed a tipping point. I woke up on Tuesday believing we were a center-right country and went to bed realizing we may simply be a divided country.

Fifty percent of American households now receive at least $2,500 in benefits from the federal government. And president Obama wants to expand that number. At the same time, median income is going down while the jobless rate is still far too high.

The hard reality is this: When the majority of Americans reward the politics of bailouts and benefits ahead of the promise of hard work, freedom and opportunity we have to question not just the viability of our message; but the viability of our country.

Our history, however, is a series of defining moments. And since our beginning, we have been a nation that has cheated history.

One of those moments happened back in the winter of 1777 at a place called Valley Forge. Many of us know the story – the American Spectator was there. The Continental Army under General Washington was on the ropes after a string of defeats. They were hungry, weary and ill-equipped. The conditions were brutal: 2,500 men – about ten percent of his army – perished that winter. Washington didn’t know how many would survive, and of those that did, he didn’t know if enough would re-enlist to carry on the struggle. But Washington refused to give up. He chose to lead. He decided to take action. He wasn’t content to just survive and keep warm. Braving the wind and cold, he drilled his men daily. He honed his tactics and forged an army in a crucible of adversity.

For us, this is a Valley Forge moment. This is a time for leadership that calls on us to re-enlist in the struggle to preserve freedom, and a leadership that drills us in the principles that made us great.

To get back on track I would suggest we focus on a few simple points: truth, oversight, action and accountability.

One of the lessons from last Tuesday is that we’ve failed to tell the American people – particularly young voters – the truth about where we are.

The truth is, on our present course, the average young person in this country is going to inherit a lower standard of living than their parents. That is unacceptable.

America is already bankrupt. We may not believe it. We may not yet feel its full effects. But we are effectively bankrupt. Our debt, which is 103 percent of our GDP, now exceeds the size of our entire economy.

The crisis is imminent. Today, we’re on the cusp of another downgrade. If interest rates go up one point, we add at least another $160 billion to our deficit every year. If rates return to historic averages, we’ll add about $640 billion to our deficit every year – which is more than our defense budget.

In two years, the Social Security disability trust fund goes bankrupt. In five years, Medicare Part A – the hospital insurance trust fund – may be bankrupt. And in ten years the costs of entitlements and interest on the debt alone will consume all available tax revenues. That means our entire military and discretionary budget will be financed entirely on borrowed – or printed – money.

The truth is we’ll never get to the point of running DOD on money borrowed from China and elsewhere. Eventually, the rest of the world will decide we can’t pay what we owe and they’ll stop lending us money. As I describe in my book, The Debt Bomb, that’s when the party is over.

That isn’t just my opinion. In 2011 Federal Reserve Ben Bernanke told Congress that these unsustainable spending levels can’t continue “because creditors would never be willing to lend to a government whose debt, relative to national income, is rising without limit.”

Here’s why this is important in the context of what happened last Tuesday.

We’ve heard a lot of talk about the left’s so-called demographic advantage and the president’s electoral firewall, and whether that firewall will hold in future elections. Let me tell you some good news. Those of us who believe in the Constitution and limited government have a much more potent firewall working in our favor: it is a mathematical and budgetary firewall. It is a firewall that tells us – in very stark terms – that we can’t afford the status quo. We don’t have the money. Sooner rather than later, the other side will have to accept reforms that are a lot closer to our principles than theirs.

The demographic advantage – at least among younger voters – is a bubble of inflated expectations that can’t be met. Where the left sees a demographic advantage I see a generation of Americans about to be drowned in debt. When that happens, our solutions will be like an ark in the storm.

Hopefully we won’t have to live through such a crisis. If we tell the truth effectively we may not have to.

So, our first task is to tell the truth. The second is oversight, which has to happen before you set priorities and get spending under control.

Oversight isn’t very popular in Washington because politicians on both sides prefer to create new programs instead of looking at whether the programs we’ve already created are working. But, I believe, oversight resonates with families because that’s how they live their lives every day. In the real world, people look their budgets and make choices. In Washington, we make excuses, and defer choices to future generations.

Oversight is about methodically and relentlessly building the case for limited government. And it’s about recognizing that big changes often happen in small steps. That’s why I release reports on all areas of the government. In my latest annual Wastebook report we found federal funding from everything from robotic squirrels to climate change musicals to caviar promotion.

Here are a few more. You can’t make this stuff up. We found:

• $27 million for Moroccan pottery classes

• $505,000 for the promotion of specialty shampoo and other beauty products for cats and dogs

• $1.3 million in corporate welfare for the world’s largest snack food producer, PepsiCo Inc.

• $350,000 for a government-funded study on how golfers might benefit from using their imagination to envision the hole to be bigger than it actually is. Really? Maybe we should have studied how to help politicians imagine a smaller hole in the budget.

The list goes on and on. And I’m adding to the list tomorrow when I’ll release a report that details more than $60 billion in non-defense spending at the Pentagon.

The point of these reports is to help the public have an understanding of government that reflects reality. And the reality is we could reduce the size of government by one-third today and no one outside of Washington would be able to tell the difference.

Oversight, again, isn’t just the responsibility of those of us in elected office. It’s the media’s responsibility as well. Many of you in this room are doing that and I salute you.

So, task number two is oversight. The last two – action and accountability – go together.

Perhaps the greatest problem I’ve seen in the Republican Party since being elected in the Class of 1994 is the gap between our words and actions. We have two forms of conservatism in Washington. One is cheap or complacent conservatism; the other is costly or courageous conservatism. One is common, the other is rare.

Cheap or complacent conservatism is the conservatism of rhetoric, pledges and pandering. Costly and courageous conservatism is a conservatism of action, solutions and sacrifice. Cheap conservatism looks for scapegoats to compensate for its failure to communicate and implement a limited government agenda. Costly conservatism is brimming with optimism and compelling solutions. Cheap conservatism treats particular areas of the budget as sacred based on political expediency. Costly conservatism treats every tax dollar as sacred based on the principles of liberty and self-government.

Whether we have cheap or costly conservatism really is up to all of us in this room, particularly those of you who are leaders in the media and interest groups. My challenge to you is don’t elevate the politicians who tell you what you want to hear; elevate the leaders who are willing to take us where we need to go.

Let me make a final point about accountability. Many want to blame our setbacks in the Senate, in particular, on the Tea Party. I agree we need to do a much, much better job of candidate recruitment. But the problem in Republican politics isn’t the challengers: it’s the incumbents: it’s the career politicians who say they are for limited government and lower taxes but make decisions that give us bigger government and higher taxes.

Voters will forgive us for trying and failing, but they won’t – nor should they – forgive us for not trying. If we align our actions with our words and primary ourselves with term limits we’ll create the kind of leadership America needs.

As we think about the basics, we do have recent models of success to draw from. In the earmark battle, for instance, no one thought we would succeed. Our initial raid against the Bridge to Nowhere failed 82 to 15. But we never gave up. We were specific, methodical and relentless. We exposed excess, took action, and voters held politicians accountable. Eventually, we ended a practice that was a terrible distraction and disgrace to our party.

The task before us is simple. Telling the truth, conducting oversight, taking action and holding politicians accountable will lead us out of our Valley Forge and on to victory.

President Obama closed with campaign with the slogan “Forward.” They later modified it with an exclamation mark so it read “Forward!” I wish we could change it to read “Fast-Forward.” But I want to leave you with a different word: “Forever.”

Our vision is not based on a sentimental optimism that is blissfully ignorant of history, and math. Our vision is a serious optimism based on enduring principles that have stood the test of time because they stand outside of time: principles that come from nature and nature’s God: principles of self-reliance, sacrificial leadership and most of all, the dignity of each person regardless of race or creed.

If we want to communicate our values clearly we need to go back to those enduring “forever” principles that built our country, and avoid the short-term politics of pandering. Doing so will address each challenge we face.

And, like our founders, we can look back at history and draw from the wisdom of those who lived through perilous times in the past. After Rome was sacked the great writer and thinker Augustine looked at a world that seemed to be coming to an end and wrote a book called the City of God in which he contrasted that eternal city with the City of Man.

It is in the eternal city we learn there is no black or white, Asian or Hispanic, male or female, and born or unborn. Though we are all imperfect and flawed, we are all children of God. And, once we choose to enter, we are all immigrants welcomed by grace.

You see, our vision welcomes all people because it is based on a view of freedom, liberty and dignity that comes from a Creator, not from the state, the King, or a board of unelected bureaucrats in Washington.

We offer a vision of shared prosperity through what Arthur Brooks calls earned success. Their vision offers shared misery through the redistribution of wealth and class envy. We uphold the dignity of all people. Their ideas diminish the dignity of all people through debt and dependency. Their vision is unsustainable, ours is sustainable. Where they offer a rendezvous with debt, we still offer a rendezvous with destiny.

From low points like Valley Forge to the debacle of Watergate, the answer is never to abandon our values. Instead, we should follow Ronald Reagan’s advice from 1975: “Our people look for a cause to believe in. Is it a third party we need, or is it a new and revitalized second party, raising a banner of no pale pastels, but bold colors which make it unmistakably clear where we stand on all of the issues troubling the people?”

As we continue to reflect, and debate, I would encourage you to face the future not with fear but faith and optimism. America is a nation – and an idea – that has cheated history many times in the past and can do so again.

Thank you. And may God bless you and our great country.

Today, at a hearing on Social Security Disability Programs, the Permanent Subcommittee on Investigations, Ranking Member U.S. Senator Tom Coburn, M.D. (R-OK) released the findings of an 18-month investigation exposing flawed methods used by the Social Security Administration to award disability benefits. The investigation found that more than a quarter of 300 randomly selected case files were awarded benefits without properly addressing insufficient, contradictory and incomplete evidence.

To read the full investigative report, "Social Security Disability Programs: Improving the Quality of Benefit Award Decisions", click here.

To read Dr. Coburn's opening statement, click here.

Key findings of the investigation

1. More than a quarter of 300 randomly selected disability case files were awarded benefits without properly addressing insufficient, contradictory and incomplete evidence. This corroborated an internal 2011 review by SSA that found that administrative law judges (ALJs) got decisions wrong or had significant errors 23-26% of the time in the areas examined by the Subcommittee.

2. Every time benefits are wrongly awarded, the cost to taxpayers is at least $300,000. The average lifetime cost of a disability award is $300,000.

3. A single judge in Oklahoma City, Howard O’Bryan, awarded more than $1.6 billion in lifetime benefits in just three years. He decided more than 5,400 cases from 2007-2009 with an approval rate over 90 percent, most of them held “on-the-record” without hearings.

4. ALJs “cut and paste” images of medical records into favorable award decisions instead of including written analysis. Judge O’Bryan had to be told numerous times to stop.

5. SSA relied on insufficient and contradictory medical evidence at every level in the application process. While the most significant problems were found at the ALJ level, problems were also found with decisions made at the state-based Disability Determination Services (DDS).

6. ALJs often gave most weight to medical records from attorneys and least weight to independent DDS doctors. Attorneys often submitted one or two page forms in which a doctor found a person totally disabled. Some ALJs called these “dead man’s reports” and “store bought opinions.”

7. ALJs failed to hold proper hearings, preventing them from collecting objective and useful information. Some hearings were less than 5 minutes long; at some hearings a claimant did not speak; and at some hearings questions were asked only by attorneys, with none from ALJs.

8. ALJs admitted late-arriving evidence to override all other medical evidence. Claimant attorneys would submit evidence days – in some cases hours – prior to an ALJ hearing. Senior SSA officials said this was strongly discouraged because it too little time was left for analysis.

9. SSA relied heavily on the vocational “grids” to find claimants disabled on their 50th or 55th birthdays. SSA finds claimants disabled using the grids four times more frequently than for meeting medical listings – a reversal of past practice.

10. SSA uses an outdated Dictionary of Occupational Titles from the 1970’s to find jobs. This relic fails, for example, to capture current labor market trends. For example, it does not contain any computer-related jobs a person could do, but includes “sorter,” “cuff folder,” and “battery stacker.”

11. “Drug and Alcohol Abuse” was deemed “not material” in 24 cases in which a claimant was awarded benefits. A 2011 SSA review, however, found that failure to explain why the significance of drug and alcohol abuse was a top reason for errors in ALJ decisions.

Examples of Flawed Disability Cases

Alabama 69. Judge Intoccia awarded disability benefits solely on a one-page document filled out the day before the hearing by the claimant's doctor at the request of the claimant's attorney.

Oklahoma Case 153. Judge Falkenstein said a woman was disabled as of April 2007 for carpal tunnel syndrome, but in July 2007 her records show her working as a bartender.

Oklahoma Case 151. Judge Keltch coached a claimant how to get higher benefits by possibly lying about a "rental agreement" with his roommate.

Virginia Case 249. A woman applied for benefits based on COPD - a breathing disorder - but was sent by her attorney to a doctor who diagnosed her with "mental retardation." Judge Erwin, testifying tomorrow, said this doctor in particular had a history doing this for attorneys. 

Oklahoma Case 181. Judge Hiltbrand awarded benefits to a child based on ADHD whose teachers described him as doing well. The judge indicated at the hearing he was gonig to apply the medical standards more loosely and award benefits in part because he "didn't want to penalize a good parent."

Oklahoma Case 109. Judge Hiltbrand awarded benefits to a woman who claimed a severe arm injury that kept her from moving it. Her doctor saw her in the parking lot unlock her truck, place her bag on the passenger seat, and steer the wheel of her vehicle - all with her right arm.

Oklahoma Case 111. Judge Howard O'Bryan awarded disability benefits to a former truck driver, whose case file contained notes from several doctors stating he could return to work with "no restrictions."

Virginia Case 257. Judge Peters held a four-minute hearing and instead of asking any questions, changes the claimant's date of disability to her 50th birthday and "gridded" her. 

Today, Health Resources and Services Administration (HRSA) Administrator Mary Wakefield, responded to a letter sent by Senators Tom Coburn, M.D. (R-OK), Michael Enzi (R-WY) and Richard Burr (R-NC) asking HRSA for a management plan to address the deficiencies and concerns outlined by two GAO reports.  

Text of the letter from HRSA, here.

On February 1, 2012, Dr. Coburn sent this letter to Senate Minority Leader Mitch McConnell regarding the National September 11 Memorial and Museum Act of 2011 (S. 1537) a bill authorizing $20 million annually for the memorial and museum. 

The group, 9/11 Parents & Families of Firefighters and WTC Victims, sent a letter supporting Dr. Coburn and a second letter expressing their opposition to S. 1537. 

Click here to read the first letter. Click here for the second letter. 

Click here to read Dr. Coburn's letter responding to concerns from the group, 9/11 Families for a Safe and Strong America, opposing his hold letter and his questioning the $20 million annual earmark. Click here to read their letter. 

On February 16th, Dr. Coburn sent this letter to Senator Schumer (D-NY) and this letter to Senator Gillibrand (D-NY), responding to a letter he received from the two senators asking him to work with them to pass S. 1537 by proposing placing a tariff on imported American flags as one potential way to pay for the bill. 

Read the letter from Senators Gillibrand and Schumer, here. 

In March, Senator Coburn sent this letter to Senator Inouye (D-HI), Chairman of the Senate Appropriations Committee, requesting clarification about the information his office provided regarding the budgetary projections of the memorial. Senator Inouye's responded with this letter. 

Dr. Coburn filed the following amendments to the Small Business Jobs and Tax Relief Act, S. 2237.

#2536__Prohibiting tax evaders from receiving government assistance, including tax credits, grants, contracts, and loans.  For additional background on this amendment, click here.

#2534__Prohibiting millionaires from receiving certain tax breaks.  As exposed in Senator Coburns report,Subsidies of the Rich and Famous, the average amount of tax breaks claimed by millionaires is $28.5 billion every year.  This amendment would pay for the $28 billion cost of S. 2230 by eliminating the following tax breaks for millionaires:  the mortgage interest deduction, rental expenses deduction, gambling loss deduction, cancelled debt deduction, electric vehicle credit, childcare tax credit, and the renewable energy credit.  For additional background on this amendment, click here.

#2535__Requiring Higher Income Americans to Pay More for their Share of Medicare Parts B&D.  For additional background on this amendment, click here.

#2537__Repealing the Obamacare Health Insurance Tax, which will increase premiums by $500 per family.  For additional background on this amendment, click here.

Coburn-Durbin amendment #2439 - Senators Coburn and Majority Whip Dick Durbin (D-IL) filed this amendment that would reduce the level of federal premium support for crop insurance participants with an Adjusted Gross Income (AGI) over $750,000 by 15 percentage points for all buy-up policies beyond catastrophic coverage. 

The Congressional Budget Office (CBO) estimates this amendment would save more than $1.2 billion dollars over ten years. Earlier this year, Senators Coburn and Durbin sent this letter to the Senate Agriculture Committee regarding their recommendations for reforming the federal crop insurance program. Additional background on the amendment, here.

Coburn amendment #2214 - This amendment would prohibit the use of public funds for political party conventions and to provide the return of previously distributed funds to the Treasury for deficit reduction. Earlier this week, Dr. Coburn introduced this legislation as a stand alone bill, S. 3257. 

Supporting documents

• View text of the legislation, here. 
• Dr. Coburn's Statement for the Congressional Record, here.
• Congressional Research Service report on 2008 Democratic and Republican national convention spending and data provided by the Federal Election Commission (FEC) on PECF expenditures used for party conventions. 
• Examples of spending by-the-numbers: Republican National Convention Committee. 
• Examples of spending by-the-numbers: Democratic National Convention Committee.
• Dr. Coburn called for the elimination of taxpayer subsidies for party conventions in his 2011 Wastebookreport, citing this report from the Congressional Research Service on federal funding for 2012 Presidential nominating conventions.
• Additional explanation of how the Presidential Election Campaign Fund (PECF) operates. 

In May, 2012, Dr. Coburn urged the Republican National Committee and Democratic National Committee to reject public financing for their respective party conventions. Read the letter sent to both the RNC and DNC and additional background on other efforts from the Republican Study Caucus (RSC) to eliminate funding for conventions in 2009: here.

Coburn amendment #2225 — To prohibit federal tax cheats from receiving federal farm subsidies. This amendment would prohibit any federal farm assistance, including farm subsidies, loans, grants and other forms of assistance from being provided to individuals and entities that are seriously delinquent in their tax debt to the United States Treasury. Additional background, here.

Coburn amendment #2288 - To establish new eligibility criteria for participation in Rural Development programs. Additional background, here.

Coburn amendment #2289 - To reduce the Market Access Program (MAP) by 20 percent. Additional background, here.

Coburn amendment #2290 - To reduce funding for USDA’s Rural Development agency by $1 billion and let the agency prioritize remaining funds. Additional background, here.

Coburn amendment #2291 - To eliminate International Forestry Programs at the U.S. Forest Service. Additional background, here.

Coburn amendment #2292 - To eliminate the Urban and Community Forestry (U & CF) program. Additional background, here. 

Coburn amendment #2293 - To limit subsidies to millionaires. Additional background, here.

Coburn amendment #2353 - To eliminate two “working lands” conservation programs: (1) the Environmental Quality Incentives Program (EQIP) and (2) the Conservation Stewardship Program (CSP). Additional background, here.

Today, Dr. Coburn agreed to pass a bill to extend the National Flood Insurance Program (NFIP) for 60 days after the Senate accepted his provision to phase out subsidized premium rates for vacation homes and second homes. Dr. Coburn's amendment will save the program - and taxpayers - $2.7 billion over the next 10 years. 

For text of the agreement, click here.

(WASHINGTON, DC) –Today the GAO released a letter report on the Small Employer Health Insurance Tax Credit in Obamacare. GAO found that “fewer small employers claimed the [tax credit] in 2010 than were estimated to be eligible.” While 170,300 small employers claimed the tax credit, GAO said “estimates of the eligible pool by government agencies and small business advocacy groups ranged from 1.4 million to 4 million” and noted the cost of credits claimed was $468 million. According to GAO, “employer representatives, tax preparers, and insurance brokers that GAO met with, the credit was not large enough to incentivize employers to begin offering insurance.” Complex rules on FTEs and average wages also limited use, according to GAO’s research.

The GAO report confirms several warnings Senators Tom Coburn, M.D. and John Barrasso, M.D., made in chapter 9 of Grim Diagnosis, their October 2010 oversight report on Obamacare. In their 2010 report, the Senators noted that business leaders were “learning that new small business tax credits in the law actually do very little and do not prevent health care costs for businesses from climbing higher.” This was one large reason they found that “few businesses appear interested in the credit.”

The Senators noted that, “rather than lowering health costs for all businesses and workers, the new law only offers a temporary credit from which one percent of individuals in America will actually benefit.” They concluded because Obamacare “headed the wrong direction,” so Congress needs to repeal the law and replace it with “policies which will spur business expansion and job growth – not policies that will increase health care costs for businesses and employees.”

Overview of Duplication & Overlap

The Department of Justice (DOJ): 253 Duplicative Programs costing $1.9 billion a year. DOJ administers 253 grants for crime prevention, law enforcement, and crime victim services through the Office of Justice Programs, the Office on Violence Against Women, and the Community Oriented Policing Services Office. These three offices awarded over 11,000 grant awards in 2010, but GAO reported that DOJ officials do not track the flow of grants to subgrantees and do not know for what purposes and activities the subgrantees are using the money. DOJ officials even told GAO that they encourage applicants to apply for as many DOJ grants as possible. The DOJ gave out $3.9 billion in grants in 2010, and since 2005, the DOJ has been given $30 billion for grants. One grant recipient told GAO that they had received so much money from the DOJ that they planned on returning some of the money because it was more than they needed.

Diesel Emissions Programs: 14 different programs costing billions each year are administered through the Department of Energy, Department of Transportation, and the Environmental Protection Agency, to reduce diesel emissions. 13 of the programs provide grants and one program provides loans for this purpose. GAO reports that each program overlaps with at least one other program “in the specific activities they fund, the program goals, or the eligible recipients of funding.” Cost: From 2007 to 2011, these diesel emissions programs cost at least $1.4 billion and at least $510 million in forgone tax revenue in FY 2010.

Early Learning and Child Care: 45 different programs costing at least $13.3 billion a year. The federal government operates 45 programs, and five tax provisions to encourage early learning and child care for children under the age of five. Cost: Federal programs for early learning and child care received at least $13.3 billion in FY2010. The five tax provisions “accounted for at least $3.1 billion of forgone tax revenue” in FY2010. Head Start, the largest program, spent $7.2 billion in FY 2010.

Employment for People with Disabilities: 50 overlapping and duplicative Programs costing approximately $3.5 billion a year. GAO reported finding 50 different programs supporting employment for people with disabilities. These 50 programs are operated by nine federal agencies and are overseen by an even greater number of congressional committees. 18 programs are specifically for veterans and service members, and 6 are for students and young adults, five of which all provide employment counseling, assessment, and case management. 22 of the 50 programs reported that they did not track or monitor any outcome measures.

Financial Literacy: 56 duplicative programs costing $30.7 million a year. GAO found 15 financial literacy programs operated by 13 different federal agencies. However, a 2011 survey conducted by the Departments of Treasury and Education found 56 financial literacy programs operated by 20 different federal agencies.

Green Building: 94 duplicative programs. GAO reported finding 94 initiatives, operated through 11 agencies, promoting green building. The Department of Housing and Urban Development (HUD), Environmental Protection Agency (EPA), and the Department of Energy operate two-thirds of the green building programs. Forty-seven of the programs are grants, nine programs provide loans, five offer tax credits, three offer tax deductions, and forty-five initiatives offer technical assistance. *Annual cost unknown because the agencies running these programs do not keep track of green building funds.

Housing Assistance: Over 160 duplicative programs costing $170 billion a year. Since the 1930s, the federal government has been involved in supporting affordable housing through the establishment of the Federal Housing Administration (FHA), and Fannie Mae and Freddie Mac. Without proper oversight, the federal government’s involvement has ballooned into a puzzle of 160 overlapping and duplicative programs, administered through 20 agencies, intended to encourage homeownership and provide affordable rental housing for low-income families.

Information Technology Investment Management: The Department of Defense (DOD) made 2,383 investments and the Department of Energy made 876 information technology investments in FY2011 for a total cost of $79 billion. Additionally, GAO found 37 investments, from a sample of investments that were duplicative between the DOD and the Department of Energy, costing $1.2 billion.

Science, Technology, Engineering, and Math (STEM) Education: 209 federal STEM programs costing approximately $3.1 billion a year. GAO found a total of 209 federal programs designed to support science, technology, engineering, and math (STEM) education. 170 programs serve postsecondary students, 75 programs served K-12 students, and 70 programs served K-12 teachers.

Support for Entrepreneurs: 53 different programs costing $2.6 billion a year. Four different agencies and departments operate 53 programs to help entrepreneurs. GAO reported that these programs, run by the Departments of Commerce, Housing and Urban Development (HUD), and Agriculture (USDA), and the Small Business Administration (SBA), overlap in their purpose resulting in inefficiency and compromising their effectiveness.

Surface Freight Transportation, Under Department of Transportation: No clearly defined role for the federal government or strategy for surface freight transportation resulting in dozens of programs with overlapping and duplicative roles in promoting passenger and freight mobility. According to GAO, “this fragmented structure makes it difficult to determine the types of freight projects that are funded and their impact on overall freight mobility.”

Unmanned Aircraft Programs: 15 Overlapping Programs estimated to cost approximately $37.5 billion between FY2012 and FY2016. GAO found 15 unmanned aircraft programs within five categories based on weight, altitude, and speed. GAO found overlap between group four and five and it is expected that another $32.4 billion will be spent to complete these programs.

This week, the Senate unanimously passed Coburn amendment #2060 limiting spending on government conferences. Summary and background here.

Dr. Coburn believes the problem with conference spending is Congress, not the GSA or any other agency. Congress has fostered a spring-break mentality at agencies by looking the other way. Too often members would rather grow government than shrink government, particularly if a parochial interest is at stake. This amendment will send a long-overdue signal that Congress is listening to the American people and taking its oversight responsibilities seriously.

Summary of the Coburn #2060 amendment:

Provides a first step in comprehensive conference spending and transparency reform by scaling back overall conference spending, establishing attendance limitations to protect from excessive and unnecessary travel, and require full online transparency of all conference spending. These reforms could save more than $65 million every year.

Establishes a basic set of requirements for conference spending, including the following:

• Reduces the amount an agency can spend on conferences to 80 percent of the amount spent in 2010.

• Caps amount that can be spent on a single conference at $500,000 (unless the agency is the primary sponsor).

• Allows non-federal foundations and sources to provide financial support for a conference, but requires a listing of such sponsors and a certification that there is no conflict of interest resulting from support received from each.

• Prohibits sponsoring more than one conference per year per organization.

• Limits to 50 the number of employees from a single agency traveling to an international conference.

Requires a quarterly summary posted on the agency’s website of each conference supported or attended by an agency in the preceding 3 months, including:

• An explanation how the conference advanced the mission of the agency;

• Total cost of attendance and support for the conference;

• Primary sponsor of the conference;

• Location of the conference;

• A justification of the location including cost efficiency of the location;

• The dates; and

• The number and a listing by title of agency and non-federal employees whose attendance at the conference was paid for by the agency.

Dr. Coburn's past efforts to make conference spending transparent by holding Congress, and federal agencies, accountable:

"Throughout our history, presidents and lawmakers cut back non-defense spending during times of war. Today, Congress must follow that precedent and begin to curb the increase in spending on nonessential activities.” --Senator Tom Coburn, 9/14/06

In the summer 2005, as Chairman of the Senate Homeland Security's Subcommittee on Federal Financial Management, Senator Coburn first launched a government wide inquiry into travel spending and asked federal agencies to report conference sponsorship and participation since 2001 and found that the government had spent over $1.4 billion sending people to meetings and conferences the last five years. The data revealed that such spending had increased 70%. When fiscal year 2006 spending is totaled, these numbers are expected to grow.

The investigation uncovered hundreds of millions of dollars wasted on sending employees to conferences of questionable value. In addition to excessive spending on airfare, hotel rooms and per diems, the Subcommittee found excessive attendance levels, where agencies were sending dozens and even hundreds of employees to the same out-of-town meeting, sometimes overseas. The Subcommittee concluded that much travel to conferences is unnecessary given the fact that videoconferencing and the Internet allow the same information to be shared and exchanged.

During his time as Chairman, Senator Coburn held two hearings on this subject at which he called 14 government witnesses to defend their agency’s travel spending records. The Subcommittee also heard testimony from a former government official who discussed a “spring break” mentality on the conference circuit and characterized most conferences as “a waste of time and money.”

The investigation also revealed that government employees traveling to lavish locales including Crete, Australia, South Africa and Hawaii will often take annual leave before or after the conference, essentially charging taxpayers the cost of a plane ticket for their personal vacations, begging the question – would the conference have been attended if the employee hadn’t been able to combine with his vacation?

Every conference attended by Federal employees should be able to stand up to the following questions:

1. Does the conference help further the Department’s mission?
2. Could the information provided at the conference be disseminated instead through a teleconference, the Internet or scholarly publication subsequent to the conference?
3. Is the location appropriate and justified?
4. Is the number of employees attending justified, and could one employee attend instead of many, and provide detailed briefings to other employees afterward?
5. Is this a wise use of tax dollars when we have an over $9 trillion national debt?
6. Could the amount spent on the conference have been better spent on a higher priority, or not spent at all?
7. This is an area the Subcommittee will continue to watch. Check back for updates.

Reports on conference spending:

• “For the Farmers or For the Fun?” - 2008 USDA report: USDA tripled conference expenditures since 2000, to $19.4 million in 2006. USDA saw a 191 percent increase in conference spending since 2000.

• “Party at the DOJ” - 2010 Department of Interior IG report: found DOI could save more than $20 million in travel costs each year by utilizing teleconferencing technology. According to the report, the Department owns $5 million worth of such equipment, but fails to fully use it, meanwhile spending millions on travel.

• “Justice Denied” - 2008 DOJ report: spent more than $312 million over 7 years on conferences. Includes $4 Meatballs, Congressional Training Sessions in Hawaii, and a Gang Prevention Event at a Palm Springs, Waldorf-Astoria Resort.

• 2008 report on HIV/AIDS conference cost taxpayers half a million dollars ($473,095), to send federal employees to Mexico.

Dr. Coburn's previous amendments on conference spending:

S. AMDT. 4787 to H.R.5631 would cap at $70 million the amount the Defense Department could spend on conferences and conference-related travel. In 2005, the Pentagon spent more than $79 million on conferences. The amendment was agreed to by voice vote on August 3, 2006 after the Senate rejected a motion to table, or kill, this amendment by a vote of 36 to 60. Roll call vote (a YEA vote is to kill the amendment and allow unlimited conference spending and a NAY vote is to support the amendment). Estimated savings: At least $9 million.

S. AMDT. 2230 to H.R. 3010 to limit reduce the Department of Health and Human Services’ funding for travel and conferences by $15 million. In 2005 alone, HHS spent $68.5 million on conferences. This amendment was agreed to by unanimous consent Oct. 27, 2005. Savings: $15 million.

S. AMDT. 2087 to H.R. 3058 limits Department of Housing and Urban Development (HUD) funding for conferences to $3 million. In 2005 alone, HUD spent $13.9 million on conferences. The agency planned to spend $12,360,010 on conferences in 2006. This amendment was agreed to by voice vote on Oct. 20, 2005. Savings: $9.36 million.

S. AMDT. 3318 to H.R. 3093 would require NASA to post details of all conferences it will sponsor during fiscal year 2008. Specifically the amendment requires NASA to post on its public Web site: the itemized expenses paid by the agency, including travel expenses and any agency expenditure to otherwise support the conference; the primary sponsor of the conference; and the location of the conference. In the case of a conference for which the agency was the primary sponsor, the agency must include a statement that: justifies the location selected; demonstrates the cost efficiency of the location; the date of the conference; a brief explanation how the conference advanced the mission of the agency; and the total number of individuals who travel or attendance at the conference was paid for in part or full by the agency. This amendment was accepted by voice vote October 15, 2007. 

With CMS' newly released Medicare hospital inpatient prospective payment system for FY2013, a new Medicare rule highlighting the Massachusetts rural floor discussion affirms the "Bay State Bailout" Dr. Coburn warned about earlier this year. 

According to the CMS rule, the following section highlights the rural floor discussion:

"...There was one urban IPPS hospital that was reclassified to rural Massachusetts (under section 1886(d)(8)(E) of the Act) which established the Massachusetts rural floor, but the wage index resulting from that hospital’s data was not high enough for any urban hospital to benefit from the rural floor policy. However, beginning with the FY 2012 wage index, the rural floor for the State is established by the conversion of a CAH to an IPPS hospital that is geographically located in rural Massachusetts. We estimate that Massachusetts hospitals will receive approximately a 5.5 percent increase in IPPS payments due to the application of rural floor."

Earlier this year in a Senate Finance Committee hearing, Dr. Coburn questioned HHS Secretary Sebelius on this special deal for Massachusetts asking about this provision under the PPACA and specifically - why HHS did not warn Congress of the manipulative provision benefitting Massachusetts but costing other states a total of $4 billion.

Read more about about the "Bay State Bailout" and Dr. Coburn's warning here.

Dr. Coburn filed the following amendments to S. 1789, the Postal Reform bill being debated in Senate this week:

Amendment #2059 - To Allow the USPS to make decisions about Post Office and facility closures. Additional background: here.

Amendment #2058— To Amend the Service Standard Requirement to Encourage the Co-Location of Post Offices in Businesses. Additional background: here.

Amendment #2060: To provide transparency, accountability, and limitations of government sponsored conferences. Additional background: here.

Amendment #2061: To require retirement-eligible USPS employees to retire. Additional background: here.

Today, Dr. Coburn filed the following four amendments to S.2204, a bill to repeal tax subsidies for big oil companies. 

Amendment 1980 - To stop corporate welfare by prohibiting large corporations from receiving federal funding from the Advanced Research Projects Agency - Energy. Additional background: here.

Amendment 1981 - To prohibit millionaires from receiving the residential energy efficient property tax credit. Additional background: here.

Amendment 1982 - To save at least $2 billion annually by reducing unnecessary, duplicative, and overlapping government energy programs. Additional background: here.

Amendment 1983 - To prohibit the use of funds for the Office of Fossil Energy's Research and Development activities. Additional background: here.

This week, Senators Coburn, Enzi, McCain, Alexander, and Burr sent this letter to Health & Human Services Secretary Sebelius requesting HHS release the results of a study on the Head Start program. The results of the Head Start "Third Grade Follow-Up Study", scheduled to be completed in September 2011, has been delayed until September 2012 without explanation. Dr. Coburn and others request an explanation.

Excerpts...

"Congress and the American people deserve the opportunity to review the evidence about whether the Head Start program is benefiting the children that it serves."

"Four years seems to be a sufficient period of time for the Department and the researchers that conducted the data collection to analyze the results."

"The American people-including the families of the estimated 904,000 children currently enrolled-deserve to understand how this program is affecting the children it serves."

Today, the Government Accountability Office (GAO) released its annual report addressing duplication and areas for costs savings throughout the federal government. Read the full report by clicking here.

Supporting documents

• Dr. Coburn's prepared testimony at the House Committee on Oversight and Government Reform: here. Highlights of the testimony: here.
• An appendix of the testimony: here.
• An Executive Summary of the 2012 GAO report: here.
• Executive Summary of the Report Card on 2011 GAO duplication report: here.
• Chart detailing 2012 GAO report cost savings: here.
• A 1966 article highlighting the proliferation of duplicative federal programs titled, "Government by Totem Pole: As federal programs proliferate and duplicate we're fast becoming The Overlapped Society".

The report reviews 51 areas of government spending, including 32 areas of extensive federal duplication, fragmentation and overlap, and 19 additional areas of opportunities for large cost savings.

Like last year’s report, which identified more than $100 billion in savings by eliminating duplicative programs, today’s findings are a testament to failed congressional efforts of oversight and a reminder Congress continues to shirk its duty to address even blatant areas of waste and mismanagement of taxpayer funding.

According to GAO Director Dodaro, “This report identifies government duplication, overlap, and fragmentation as well as other cost savings and revenue enhancement opportunities. Its findings involve a wide range of government missions and touch virtually all major federal departments and agencies.”

EXAMPLES FROM THE 2012 GAO DUPLICATION REPORT:

Science, Technology, Engineering, and Mathematics (STEM) Education. 

There are 209 federal STEM education programs, administered by 13 different federal agencies, costing taxpayers more than $3 billion annually.

Department of Justice Grants

Since 2005, Congress has spent $30 billion in overlapping Department of Justice grants for crime prevention police and victims services from more than 200 DOJ grant programs, and $3.9 billion in grants just in 2010.

Housing Assistance

GAO exposes there are “20 different entities administer 160 programs, tax expenditures, and other tools,” that support homeowners and renters.” In addition, there are 39 programs, tax expenditures, and other tools provide assistance for buying, selling or financing a home, and eight programs and tax expenditures provide assistance for rental property owners.

Support to Private Sector on Green Buildings

There are 94 federal initiatives to encourage “green building” in the private sector, run by 11 federal agencies.

Diesel Emissions

There are 14 programs and three tax expenditures that sole or joint purpose is to reduce diesel emissions.

GAO’S REPORT CARD ON WASHINGTON

Today GAO also released a report card on Washington, detailing action taken and not taken by Congress and the Executive Branch, on the recommendations included in last year’s first annual GAO duplication report.

The GAO found Congress has refused to enact 60 percent of the recommendations it was given by GAO, while the Executive Branch has not addressed 63 percent of the recommendations GAO directed to it. Meanwhile, Congress has only fully implemented 4 (13%) of the recommendations it was given by GAO, and the Executive Branch fully addressed 19 (13%) of its recommendations.

Combined, Washington fully addressed only four of the 81 areas identified by GAO, representing a mere five percent. Meanwhile, Congress and the Executive Branch completely ignored 21 percent of the areas in desperate need of reform, as outlined by GAO.

Areas “partially addressed” in truth, have not been fixed at all and taxpayers have realized little to no savings from these beginning steps. In short, 153 specific recommendations, 87 percent, made by GAO last year have not been fully implemented.

GAO's findings reinforce the fact that more government is not always the solution and gives us a picture of what happens to the federal budget when the government continues to grow, and spend, out of control.

As part of my own efforts to address duplication throughout the federal budget, in July 2011, I released Back in Black, a comprehensive deficit reduction plan scrutinizing every corner of the federal budget for savings. Back in Black listed hundreds of specific proposals which together would eliminate more than $9 trillion of deficit spending over ten years.

Today, Senators Coburn and Burr (R-NC) unveiled the Seniors’ Choice Act, a legislative proposal to help America’s seniors by building a stronger, more sustainable Medicare program through immediate and longer-term reforms, many rooted in long-standing, bipartisan ideas. Non-partisan experts have warned the current Medicare program is facing insolvency due to unsustainable growth, and the Seniors’ Choice Act would fix its shortcomings so that it remains a viable option for seniors participating in the program now and for future enrollees.

The Seniors’ Choice Act blends many of the short term Medicare reforms proposed by Senators Coburn and Lieberman (I-CT) with the longer-term reforms that build on ideas put forward by Alice Rivlin, former director of the independent Congressional Budget Office, and former Senator Pete Domenici (R-NM), as well as the bipartisan Medicare Commission led by former Senator John Breaux (D-LA) and former Congressman Bill Thomas (R-CA). By incorporating thoughtful elements from these proposals into its framework, the Seniors’ Choice Act can help move the debate forward about how to craft Medicare reform to ensure the program remains strong for seniors today and in the future.

Beginning in 2014, the Seniors’ Choice Act would give patients in traditional Medicare a new benefit. For the first time, seniors would have the peace of mind that they are protected against high out-of-pocket medical costs and will have targeted and coordinated care when they need it. This policy proposal builds on recommendations of President Obama’s bipartisan Fiscal Commission and the bipartisan Lieberman-Coburn Medicare Reform proposal.

The Seniors’ Choice Act outlines other commonsense reforms that may also be implemented as soon as 2014. These include providing seniors with a unified deductible and predictable cost-sharing, gradually increasing the eligibility age and modestly increasing premiums.

Immediate Reforms: Better Benefits

The Seniors’ Choice Act gives seniors new, strengthened benefits:

• Seniors in traditional Medicare will have peace of mind that they are protected from unexpected, high medical costs by limiting their maximum out-of-pocket medical expenses under Medicare Parts A and B.

• Seniors in traditional Medicare who would otherwise be at risk because of their health care needs will be able to benefit from targeted care coordination when they need it.

• Many seniors will save money. Modernizing Medigap and rationalizing cost-sharing will offer many seniors the chance to save money each month.

The longer-term framework of the Seniors’ Choice Act, which would bring competition and choice to Medicare, would be adopted in 2016. Premium support would strengthen Medicare by giving seniors the right to choose the Medicare plan that best meets their needs. Traditional Medicare Fee-For-Service (FFS) and private plans would be forced to compete head-to-head. Under the Seniors’ Choice Act, seniors will have similar types of choices as Members of Congress currently enjoy. They may choose to either keep their traditional FFS, or they may switch to a more affordable, better coordinated plan that meets their health care needs.

Longer-Term Reforms: Better Choices

• Premium support is a patient-centered approach to strengthening Medicare. Instead of a one-size-fits-all approach to Medicare, seniors will have the choice of a better benefit that meets their individual health care needs. 

• Premium support puts patients and doctors back in charge of their health care decisions, instead of the President’s unelected, unaccountable board of bureaucrats—the Independent Payment Advisory Board—with the power to cut Medicare payments to doctors, which will threaten patients’ access to care. 

• Medicare will compete for patients and be forced to give seniors and taxpayers the best deal for their dollar. 

• Seniors have benefited from choice and competition in Medicare Part D, which has enabled seniors to have an affordable prescription drug benefit. Seniors should benefit from the same kinds of choices and competition for their entire Medicare benefit.

• Premium support will strengthen Medicare for seniors by giving them the ability to choose the Medicare plan that will best work for them, just like they do with their Medicare prescription drug coverage today.

You may read more about the Seniors’ Choice Act by following the links below: 

The Seniors’ Choice Act: Full Report

Seniors’ Choice Act: Better Benefit for Seniors 

Seniors’ Choice Act: Questions & Answers

Seniors’ Choice Act: Illustrative Patient Scenarios

Medicare by the Numbers

MCPA vs. IPAB 

How Seniors’ Choice Act Builds on Bipartisan Proposals

Dr. Coburn filed the following amendments to the STOCK Act (S. 2038), a bill which would prohibit Members of Congress and staff from using nonpublic information derived from their official positions for personal benefit. 

Amendment 1473: to require that all legislation be reviewed by CRS before it is considered by the Senate to determine whether new duplicative and overlapping Federal programs are being created. Background information: here.

Amendment 1474: to require legislation to be posted online for 72-hours before a vote in congress. Background information: here.

Amendment 1475: to establish a permanent earmark ban. Background information: here.

Amendment 1476: Substitute (Certification Amendment).

Citizens Against Government Waste letter supporting all of Dr. Coburn's amendments to the STOCK Act.

National Taxpayers Union vote alert supporting Amendment #1473.

In response to a Wall Street Journal article out this week exposing potentially fraudulent practices by the law firm of Binder & Binder for its handling of disability cases, Dr. Coburn requests the Social Security Administration Commissioner Michael Astrue to review the disability claims of individuals represented by this law firm. Today, the Wall Street Journal reports Dr. Coburn's request. 

PDF of the letter to SSA Commissioner Michael Astrue: here

Dr. Coburn also sent a letter to Senators Baucus and Hatch the Chairman and Ranking Member of the Senate Finance Committee today, regarding the need for an attorney for the federal government at Administrative Law Judge disability hearings.

PDF of the letter to the Senate Finance Committee: here

Today, Senators Coburn and Feinstein circulated a letter to their colleagues in the Senate regarding the ethanol subsidies set to expire on December 31, 2011 and cautioning against including the ethanol blenders credit (VEETC) in the end-of-the-year spending bill. 

PDF of the letter: here

Today, Dr. Coburn has asked Senate leadership for a roll call vote on the following amendment to S. 1867, the Department of Defense Authorization Bill.

Coburn Amendment 1369 - Provide Funding for Students and Local Schools by closing unnecessary Defense Department schools

• DoD operates 64 schools on 16 military installations in the U.S called the Domestic Dependent Elementary and Secondary Schools (DDESS). Today 26,000 students are taught by 2,300 teachers who are DoD employees.

• A number of schools were originally justified because the post-World War II military was racially integrated while some of the local schools where military bases were located were still segregated. DDESS was initially established when schools in the South were segregated, however it is no longer clear why the system is still necessary, or why the Defense Department plans to spend $1.2 billion for FY 2011-FY 2015 to rebuild these schools, raising the cost per student from $51,000 in FY 2011 to $81,000 in FY 2015. [1] [3]

Despite generous funding, a recent report by the Center for Public Integrity noted:

“Conditions are so bad [on military-run schools] that some educators at base schools envy the civilian public schools off base, which admittedly have their own challenges. Also, some of the new schools in town make our schools look like a prison,” says David C. Primer, who uses a trailer as a classroom to teach students German at the vaunted Marine headquarters in Quantico, Va., just 30 miles south of the nation‘s capital, in one of the country‘s most affluent suburbs.[2]

• DoD must provide quality educational opportunities for the children of our men and women in uniform serving overseas where English-speaking schools are not available and the overseas schools appear to be meeting that goal. This amendment would not affect any schools outside the United States such as the DDESS schools in Cuba or Puerto Rico.

• This amendment would adopt a recommendation from the National Commission on Fiscal Responsibility and Reform who also recommended closing DDESS and allowing those students to attend local schools just as students of military parents do elsewhere in the country.[3]

• This amendment would allow the Secretary of Defense to transfer up to $12,000 per student per year to any schools affected by this closure. This amendment would allow nearly four years for DOD to close the domestic DDESS.

• This amendment would only affect schools in the DDESS system (except for Cuba and Puerto Rico). The full list of schools and installations can be found here: http://www.am.dodea.edu/ddessasc/districts/communitylocations.html.

[1] “Domestic Dependent Elementary and Secondary Schools, ?DDESS/DODDS – Cuba History,” http://www.am.dodea.edu/ddessasc/aboutddess/description_history.html, Accessed May 12, 2011.

[2] Lombardi, Kristen, ?Daddy, Why is My School Falling Down?? Newsweek, June 27, 2011, http://www.newsweek.com/2011/06/26/military-children-s-schools-in-disrepair.html.

[3] National Commission on Fiscal Responsibility, “The Moment of Truth: Report of the National Commission on Fiscal Responsibility and Reform,” Dec. 1,2010, http://www.fiscalcommission.gov/sites/fiscalcommission.gov/files/documents/TheMomentofTruth12_1_2010.pdf

As members of the Senate Finance Committee with jurisdiction over the Medicare program, Senators Coburn and Hatch send this letter to Secretary Sebelius today detailing their concerns regarding the lack of program enforcement by the Centers for Medicare & Medicaid Services (CMS) and the risk this inaction poses to Medicare beneficiaries and the Medicare Trust Funds. 

On September 27th, Dr. Coburn and Senator Hatch sent this letter to CMS expressing initial concerns to which CMS Administrator, Dr. Donald Berwick, responded on November 9th with this.

In the controversial health care law the White House and Democrats on Capitol Hill rammed through Congress in 2010—The Patient Protection and Affordable Care Act (PPACA)— the authors of the bills included dozens and dozens of mandates and deadlines for federal agencies implementing the health law.

On October 4, 2010, Senator Coburn’s office released a report from the Congressional Research Service showing the number of deadlines mandated by the Patient Protection and Affordable Care Act (PPACA) that the U.S. Department of Health and Human Services (HHS) had missed. The analysis by the nonpartisan CRS found that HHS failed to fulfill its requirements in seven of 22 deadlines before September 23, 2010, which was the six-month mark of the law being enacted.

On November 1, 2011, in a second report to Dr. Coburn, the non-partisan Congressional Research Service compiled a list of deadlines mandated in the new health care law, that the Department of Health & Human Services has failed to meet. Out of the 30 deadlines included in the report that passed since the prior report, HHS has gets a "late" or "incomplete" on 18 (or more than half) of these deadlines under the law. The report also provides:

• updated information on a number of deadlines that were included in the earlier memo for which no or only partial implementation action had been taken through April 1, 2011.

• summaries of the PPACA provisions requiring the HHS Secretary or another federal entity to take a specific action by a specific date during the period of March 24, 2011, through October 15, 2011.

The effect of the two reports means that today, over a year and a half since the enactment of PPACA, HHS has cumulatively missed over one-third of the deadlines mandated by PPACA – missing 38 of 101 mandated deadlines. Some of these deadlines were missed by months, while other deadlines have failed to produce any action at all. HHS has also missed several deadlines to report to Congress on specific policy considerations and possible methods of enhancing health care decision making.

Ironically, while HHS is failing to comply with federal law, the administration is rushing to implement a failed health law that will force all American families, physicians, and businesses to comply with a dizzying array of federal mandates, regulations, and requirements. To protect the quality health care that Americans have and to actually fix the problems in our health care system, Congress must repeal this law and replace it with patient-centered reforms that improve quality and access while reducing costs, and put federal spending on a more sustainable path.

For a full table listing the missed deadlines, click here.

Today, Senators Coburn and Barbara Boxer sent the following letter to the Department of Education’s Inspector General asking for an examination of American law schools. Specifically, they asked the Department to provide information about key law school job placement, bar passage and loan debt metrics in light of serious concerns that have been raised about the accuracy and transparency of information being provided to prospective law school students. 

See below for the full text of the letter below or click here for a PDF version:

October 14, 2011

To help better inform Congress as it prepares to reform the Higher Education Act, we write to request an examination of American law schools that focuses on the confluence of growing enrollments, steadily increasing tuition rates and allegedly sluggish job placement.

Recent media stories reveal concerning challenges for students and graduates of such schools. For example, The New York Times reported on a law school that “increased the size of the class arriving in the fall of 2009 by an astounding 30 percent, even as hiring in the legal profession imploded.” The New York Times found the same school is ranked in the bottom third of all law schools in the country and has tuition and fees set at $47,800 a year but reported to prospective students median starting salaries rivaling graduates of the best schools in the nation “even though most of its graduates, in fact, find work at less than half that amount.”

Other reports question whether or not law schools are properly disclosing their graduation rates to prospective students. Inside Higher Ed recently highlighted several pending lawsuits which “argue that students were essentially robbed of the ability to make good decisions about whether to pay tuition (and to take out student loans) by being forced to rely on incomplete and inaccurate job placement information. Specifically, the suits charge the law schools in question (and many of their peers) mix together different kinds of employment (including jobs for which a J.D. is not needed) to inflate employment rates.”

Media exposes also reveal possible concerns about whether tuition and fees charged by law schools are used directly for legal education, or for purposes unrelated to legal education. For example, The New York Times reports “law schools toss off so much cash they are sometimes required to hand over as much as 30 percent of their revenue to universities, to subsidize less profitable fields.” The Baltimore Sun recently reported on the resignation of the Dean of the University of Baltimore (UB) Law School, who said he resigned, in part, over his frustration that the law school’s revenue was not being retained to serve students at the school. In his resignation letter, UB’s Dean noted: “The financial data [of the school] demonstrates that the amount and percentage of the law school revenue retained by the university has increased, particularly over the last two years. For the most recent academic year (AY 10-11), our tuition increase generated $1,455,650 in additional revenue. Of that amount, the School of Law budget increased by only $80,744.”

To better understand trends related to law schools over the most recent ten-year window, we request your office provide the following information:

1. The current enrollments, as well as the historical growth of enrollments, at American law schools – in the aggregate, and also by sector (i.e., private, public, for-profit).

2. Current tuition and fee rates, as well as the historical growth of tuition and fees, at American law schools – in the aggregate, and also by sector (i.e., private, public, for-profit).

3. The percentage of law school revenue generated that is retained to administer legal education, operate law school facilities, and the percentage and dollar amount used for other, non-legal educational purposes by the broader university system. If possible, please provide specific examples of what activities and expenses law school revenues are being used to support if such revenue does not support legal education directly.

4. The amount of federal and private educational loan debt legal students carried upon graduation, again in the aggregate and across sectors.

5. The current bar passage rates and graduation rates of students at American law schools, again in the aggregate and across sectors.

6. The job placement rates of American law school graduates; indicating whether such jobs are full- or part-time positions, whether they require a law degree, and whether they were maintained a year after employment.

In your final analysis, please include a description of the methodology the IG employed to acquire and analyze information for the report. Please also note any obstacles to acquiring pertinent information the agency may encounter.

We thank you in advance for your time and attention to this matter. Please feel free to contact us if you have any questions concerning this request.

Sincerely,

Tom A. Coburn, M.D. Barbara Boxer

U.S. Senator, Oklahoma U.S. Senator, California

(Articles enclosed)

Inside Higher Ed

Suing Over Jobs

August 11, 2011

For the last year, the Education Department and Congress have debated measures of "gainful employment" for graduates of for-profit vocational programs. And media outlets have competed for the best stories about unemployed liberal-arts graduates. But the question of whether higher education can be held responsible for failing to warn would-be students about the poor job prospects of graduates may really be taking off with regard to law schools.

On Wednesday, a New York City law firm filed class actions against two law schools -- New York Law School and Thomas M. Cooley Law School -- charging that the job placement information they released to potential students was sufficiently inaccurate as to constitute fraud. Those suits follow a similar one filed in May against Thomas Jefferson School of Law. All of the suits argue that students were essentially robbed of the ability to make good decisions about whether to pay tuition (and to take out student loans) by being forced to rely on incomplete and inaccurate job placement information. Specifically, the suits charge that the law schools in question (and many of their peers) mix together different kinds of employment (including jobs for which a J.D. is not needed) to inflate employment rates.

All three law schools deny the charges. And Cooley has already filed a defamation suit against the lawyers suing it. But the litigation comes amid a broader debate over whether the American Bar Association and others are doing enough to promote the release of accurate information, and whether there are too many law schools for the current job market.

While legal experts were still examining the lawsuits and were generally not ready to weigh in on whether or not they will succeed, several said that the litigation points to longstanding problems with how job placement has been tracked, and that changes currently under consideration are overdue.

"The fact that you have some serious class action law firms filing suit should give anybody pause," said William D. Henderson, a professor of law and director of the Center on the Global Legal Profession at Indiana University, and a frequent author on job placement issues. "The whole industry hasn't released useful numbers for consumers," he said.

Henderson said that he strongly backed current moves by the American Bar Association (likely to then be adopted by U.S. News & World Report for its rankings) to shift from a standard of being employed nine months after graduation to being employed in a job for which a J.D. is needed. Those suing today (and those in recent years who were disappointed by their success at finding jobs) relied on statistics that didn't exclude those whose "jobs" were fellowships paid for by their law schools, who were in part-time or temporary jobs, or who were in jobs they could have gotten before they went to law school, he said.

Several years ago, Henderson started noticing and writing about the seeming oddity that bar passage rates were declining at a time when law schools were reporting increases in employment of graduates. For this to be true, he speculated, more people were getting jobs that didn't require them to go to law school. "You are counting people who are selling insurance," he said. "Anybody can find a job to pay the rent."

The New Lawsuits

The new lawsuits are class actions on behalf of three graduates of New York Law School and four from Thomas Cooley. (Both are freestanding law schools.)

Jesse Strauss, one of the lawyers bringing the suits, said in a briefing for reporters Wednesday that he was not denigrating the quality of the legal education provided by the law schools, and that he knew good lawyers who were graduates of each institution. But he said that the information about job placement rates was deceptive. "This is more like a false advertising claim than a product liability claim," he said.

Strauss said that the deceptive information about job placement rates is "distorting the market." With better information, he said, some students wouldn't go to law school, and the population of new lawyers would shrink.

The lawsuit charges that the schools' methods of reporting their placement rates gave would-be students an inaccurate view of their likely outcomes.

"[T]he school during the class period claims that a substantial majority of its graduates -- roughly between 75 and 80 percent -- secure employment within nine months of graduation. However, the reality of the situation is that these seemingly robust numbers include any type of employment, including jobs that have absolutely nothing to do with the legal industry, do not require a J.D. degree or are temporary or part-time in nature," the suit against Thomas Cooley says. "Rather, if Thomas Cooley was to disclose the more pertinent employment statistic -- i.e., those graduates who have secured full-time, permanent positions for which a J.D. degree is required or preferred -- the numbers would drop dramatically, and could be well below 30 percent, if not even lower."

The suit against New York Law School states that it "blatantly manipulates" its placement statistics (which suggest that 92 percent of last year's class is employed). The suit says that the law school engages in numerous efforts to "pretty up" its statistics, such as including part-time work, and including the 5.6 percent of its employed graduates who are in temporary fellowships funded by the law school -- not in real jobs.

The law schools released statements that did not offer point-by-point rebuttals of the suits, but defended the integrity of their statistics. "To the extent the lawsuit challenges our post-graduation employment and salary statistics, we stand by our reporting to the National Association for Law Placement, and any claims that prospective students or our graduates have been misled or legally harmed by our reporting are simply baseless," said the statement from Thomas Cooley. (Even as the law school is being questioned over its job placement record, Thomas Cooley is expanding -- and this week announced plans to open a campus in Florida.)

A statement from New York Law School said: "These claims are without merit and we will vigorously defend against them in court."

The Broader Debate?

What's next in the debate over law placement and these legal cases is the subject of much debate. Officials from the ABA, the Association of American Law Schools and NALP: The Association for Legal Career Professionals did not respond to requests for comment on Wednesday. Privately, two law school officials expressed doubts about whether the class actions would succeed in court, but indicated that defending against them might be embarrassing for the law schools involved and for legal education generally.

For an example of the potential public relations challenges, consider the response of Thomas Jefferson to its class action. As reported in the blog Above the Law, Thomas Jefferson defended itself by noting that the U.S. News job placement figures on which the plaintiff relied were adjacent to figures in the magazine for the law school's bar passage rate. The law school's bar passage rate was lower and Thomas Jefferson's rate many years was "significantly lower" than the employment rate, the law school argues in its brief. So "any reasonable reader" would know that meaningful numbers of the law school's graduating classes were not working as lawyers. The blog's headline for the post: "Is the Answer Worse Than the Allegations?"

While the three law schools that have been sued are not among the nation's most prestigious, the lawyers who sued on Wednesday stressed that they saw the issue as going well beyond those institutions. At the news conference, they pointed to a recent article in The New Republic that analyzed data from an unnamed "top 50" law school, suggesting that one-third of graduates reporting themselves employed are in part-time positions -- meaning that well under half of graduates of a recent class are employed in full-time permanent positions, not the healthy majority that the official statistics would suggest.

Kyle McEntee, executive director of Law School Transparency, a group that has critiqued job placement rates at many law schools, said he was not surprised by the lawsuits. "I think we are going to see more of them," he said.

He said that the moves by the ABA are in the right direction, but that his group wants to see even more information. Law School Transparency urges law schools to release, graduate by graduate, exactly what happens to each new lawyer (without their names). That way prospective students won't get deceived by averages that may be skewed by a few well-compensated lawyers, and will be able to distinguish between true stepping-stone positions (judicial clerkships, for example) and volunteer work that doesn't put someone on the fast track.

Will the ABA Reforms Work?

The proposed ABA surveys on employment deal with many of the criticisms that have been made of past data. For instance, they would ask specifically about whether positions are funded by the law school, whether positions are long term or short term, etc.

But there is controversy over whether these efforts will work. NALP, which has been the primary source of law school placement data, has expressed fears that law schools will no longer collect data for its surveys, and that it is better able than the ABA to analyze the data. (A limitation of NALP's data is that they are not available institution-by-institution, which is why U.S. News's rankings, which include institutional data, have become so valued by law school applicants and so important to law schools.)

Henderson, of Indiana University, said that the ABA may unintentionally supplant NALP, and leave the law school world without anyone capable of truly analyzing the data. The ABA, he wrote in a recent column for The National Law Journal, "has a long track record of releasing mountains of data in a format that makes it very difficult to analyze the industry or make meaningful school-to-school comparisons."

With truly good data, he predicted, the law school market would change, with some law schools forced to improve their programs and with others disappearing.

But Henderson added that he's not certain that -- even with better data -- there won't be disappointed (and impoverished) law school grads in the years ahead. "You've got 22- and 23-year-olds who have an image of lawyers made by popular culture," he said. "They've never bought a house before, and now they can get a loan of over $100,000 to go to law school. This is not a group of people who are going to do rigorous due diligence on the decision to borrow."

— Scott Jaschik

New York Times

July 16, 2011

Law School Economics: Ka-Ching!

By DAVID SEGAL

WITH apologies to show business, there’s no business like the business of law school.

The basic rules of a market economy — even golden oldies, like a link between supply and demand — just don’t apply.

Legal diplomas have such allure that law schools have been able to jack up tuition four times faster than the soaring cost of college. And many law schools have added students to their incoming classes — a step that, for them, means almost pure profits — even during the worst recession in the legal profession’s history.

It is one of the academy’s open secrets: law schools toss off so much cash they are sometimes required to hand over as much as 30 percent of their revenue to universities, to subsidize less profitable fields.

In short, law schools have the power to raise prices and expand in ways that would make any company drool. And when a business has that power, it is apparently difficult to resist.

How difficult? For a sense, take a look at the strange case of New York Law School and its dean, Richard A. Matasar. For more than a decade, Mr. Matasar has been one of the legal academy’s most dogged and scolding critics, and he has repeatedly urged professors and fellow deans to rethink the basics of the law school business model and put the interests of students first.

“What I’ve said to people in giving talks like this in the past is, we should be ashamed of ourselves,” Mr. Matasar said at a 2009 meeting of the Association of American Law Schools. He ended with a challenge: If a law school can’t help its students achieve their goals, “we should shut the damn place down.”

Given his scathing critiques, you might expect that during Mr. Matasar’s 11 years as dean, he has reshaped New York Law School to conform with his reformist agenda. But he hasn’t. Instead, the school seems to be benefitting from many of legal education’s assorted perversities.

N.Y.L.S. is ranked in the bottom third of all law schools in the country, but with tuition and fees now set at $47,800 a year, it charges more than Harvard. It increased the size of the class that arrived in the fall of 2009 by an astounding 30 percent, even as hiring in the legal profession imploded. It reported in the most recent US News & World Report rankings that the median starting salary of its graduates was the same as for those of the best schools in the nation — even though most of its graduates, in fact, find work at less than half that amount.

Mr. Matasar declined to be interviewed for this article, though he agreed to answer questions e-mailed through a public relations representative.

Asked if there was a contradiction between his stand against expanding class sizes and the growth of the student population at N.Y.L.S., Mr. Matasar wrote: “The answer is that we exist in a market. When there is demand for education, we, like other law schools, respond.”

This is a story about the law school market, a singular creature of American capitalism, one that is so durable it seems utterly impervious to change. Why? The career of Richard Matasar offers some answers. His long-time and seemingly sincere ambition is to “radically disrupt our traditional approach to legal education,” as it says on his N.Y.L.S. Web page. But even he, it seems, is engaged in the same competition for dollars and students that consumes just about everyone with a financial and reputational stake in this business.

“The broken economic model Matasar describes appears to be his own template,” wrote Brian Z. Tamanaha, a professor at Washington University Law School in St. Louis, in a blog posting about Mr. Matasar last year. “Are his increasingly vocal criticisms of legal academia an unspoken mea culpa?”

A PRIVATE, stand-alone institution located in the TriBeCa neighborhood of downtown Manhattan, New York Law School was founded in 1891 and counts Justice John Marshall Harlan among its most famous graduates. The school — which is not to be confused with New York University School of Law — is housed in a gleaming new 235,000-square-foot building at the corner of West Broadway and Leonard Street.

That building puts N.Y.L.S. in the middle of a nationwide trend: the law school construction boom. As other industries close offices and downsize plants, the manufacturing base behind the doctor of jurisprudence keeps growing. Fordham Law School in New York recently broke ground on a $250 million, 22-story building. The University of Baltimore School of Law and the University of Michigan Law School are both working on buildings that cost more that $100 million. Marquette University Law School in Wisconsin has just finished its own $85 million project. A bunch of other schools have built multimillion dollar additions.

N.Y.L.S. has participated in another national law school trend: the growth in the number of enrollees. Last year, law schools across the country matriculated 49,700 students, according to the Law School Admission Council, the largest number in history, and 7,000 more students than in 2001. N.Y.L.S. grew at an even faster clip. In 2000, the year Mr. Matasar took over, the school had a total of 1,326 full- and-part-time students. By 2009, the figure had risen to 1,596.

The jump seems to contradict one of Mr. Matasar’s core tenets.

“Can class size be increased without damaging quality?” he asked in a 1996 Florida Law Review article. “Can class size be increased without assurances that jobs will be available for the increased number of graduates? Can class size be increased without also providing more staff, faculty, books and service? Increase class size? No!”

Did Mr. Matasar change his mind? In an e-mail, he cited the unpredictability of yield rates, which is the percent of students who accept an offer of admission. There was more than one year of yield surprises under Mr. Matasar, the largest of which came in 2009, when the incoming class leapt by 171 students.

It was a very profitable surprise, worth about $6.7 million in gross revenue. Mr. Matasar would not discuss the added costs of teaching what became known at the school as “the bulge class.” But faculty members, some of whom were offered the chance to take on additional courses, estimate that, at most, the school had to spend about $500,000 more that year on teaching.

This windfall, it turns out, was perfectly timed. Because as all those students were signing up for their first year at N.Y.L.S., a little-noticed drama was unfolding that involved the financing for that brand-new building.

THREE years earlier, in 2006, the school had floated $135 million worth of bonds to finance construction of the new building, at 185 West Broadway. At the time, Moody’s rated the bonds A3, placing them squarely in the “come and get ’em” category for investors. The rating reflected N.Y.L.S.’s strong balance sheet and the quality of its management, Moody’s said.

Equally important, N.Y.L.S. was — and is — in a very lucrative business. Like business schools and some high-profile athletic programs, law schools subsidize other fields in universities that can’t pay their own way.

“If my president were to say ‘We’ll never take more than 10 percent of your revenue,’ I’d say ‘God bless you,’ and we’d never have to talk again,” says Lawrence E. Mitchell, the incoming dean of the Case Western Reserve University School of Law in Cleveland. “But having just come from a two-day meeting of new and current deans organized by the American Bar Association, I can tell you that some law schools pay 25 or even 30 percent.”

Among deans, the money surrendered to the administration is known informally as “the tax.” Even in the midst of a merciless legal downturn, the tax still pumps huge sums into universities, in part because the price of a law degree continues to climb.

From 1989 to 2009, when college tuition rose by 71 percent, law school tuition shot up 317 percent.

There are many reasons for this ever-climbing sticker price, but the most bizarre comes courtesy of the highly influential US News rankings. Part of the US News algorithm is a figure called expenditures per student, which is essentially the sum that a school spends on teacher salaries, libraries and other education expenses, divided by the number of students.

Though it accounts for just 9.75 percent of the algorithm, it gives law schools a strong incentive to keep prices high. Forget about looking for cost efficiencies. The more that law schools charge their students, and the more they spend to educate them, the better they fare in the US News rankings.

“I once joked with my dean that there is a certain amount of money that we could drag into the middle of the school’s quadrangle and burn,” said John F. Duffy, a George Washington School of Law professor, “and when the flames died down, we’d be a Top 10 school. As long as the point of the bonfire was to teach our students. Perhaps what we could teach them is the idiocy in the US News rankings.”

For years, it made economic sense for smart, ambitious 22-year-olds to pay the escalating price for a legal diploma. Law schools have had a monopolist’s hold on the keys to corporate lawyerdom, which pays graduates six-figure salaries.

But borrowing $150,000 or more is now a vastly riskier proposition given the scarcity of Big Law jobs. Of course, that scarcity hasn’t been priced into the cost of law school. How come? In part, it’s because schools have managed to convey the impression that those jobs aren’t very scarce.

For instance, although N.Y.L.S. is ranked No. 135 out of the roughly 200 schools in the US News survey, it asserts in figures provided to the publisher that nine months after graduation, the median private-sector salary of alums who graduated in 2009 — which is the class featured in the most recent US News annual law school issue — was $160,000. That is exactly the same figure cited by Yale and Harvard, the top law schools in the country.

Mr. Matasar stood by that number, but acknowledged that it did not give a complete picture of the prospects for N.Y.L.S. grads. He noted that the school takes the over-and-above step of posting more granular salary data on its Web site.

“In these materials and in our conversations with students and applicants,” he wrote, “we explicitly tell them that most graduates find work in small to medium firms at salaries between $35,000 and $75,000.”

Determining exactly how many graduates make even those relatively modest salaries isn’t easy. The information posted online by N.Y.L.S. about the class of 2010 says that only 26 percent of those employed reported their salaries. The nearly 300 students who reported being employed but said nothing about their salaries — who knows?

Like all other law schools, N.Y.L.S. collects this job information without anyone else looking at the raw data or double checking the math. Which gets to another dimension of the law school business that other companies might envy: a lack of independent auditing, at least when it comes to these crucial employment stats. It’s kind of like makers of breakfast cereal reporting the nutrition levels of their products, without worrying that anyone will actually count the calories.

THOUGH astoundingly resilient as businesses, law schools have always had a glaring liability: they generally sell just one product, legal diplomas. This lack of diversification means that if enrollment drops, a school’s balance sheet will suffer.

Like all stand-alone institutions, N.Y.L.S. is even more dependent on student tuition than those attached to universities, and Moody’s highlighted this fact in its 2006 appraisal of the school’s bonds. Under a section about potential “challenges” that could lead to a downgrade, Moody’s cited “significant and sustained deterioration of student market position.”

A downgrade would be expensive for the school because it would mark the bonds as riskier, which would force the school to pay higher interest rates in the future.

In May of 2009, a month before the official end of the recession, Moody’s issued a new report and suddenly, a downgrade seemed like a real possibility. One problem was that applications to the school for the upcoming class of 2009, Moody’s reported, were down 28 percent compared with the volume the year before. The rating agency changed its outlook on the bonds from “stable” to “negative,” which is bond-speak for “If current trends continue, a downgrade is coming.”

But just three months later, the enrollment scare was over. In the fall of 2009, the incoming class was N.Y.L.S.’s largest ever — 736 students. (Only one law school in the country, Thomas M. Cooley in Michigan, matriculated a greater number.)

Some faculty members were happy to enhance their salaries by teaching another course. Others were appalled at what the super-sized class would mean for students.

“At a school like New York Law, which is toward the bottom of the pecking order, it’s long been difficult for our students to find high-paying jobs,” said Randolph N. Jonakait, a professor at N.Y.L.S. and a frequent critic of Mr. Matasar’s. “Adding more than 100 students to an incoming class harms their employments prospects. It’s always been tough for our graduates. Now it’s tougher.”

Was Mr. Matasar more worried about bond ratings than the fortunes of his new students? Several faculty members said, and he confirmed, that the bonds were part of discussions about the financial health of the school in 2009.

“However,” Mr. Matasar wrote, “N.Y.L.S. never promised (nor needed to promise) anyone that it would increase enrollment to meet debt service obligations.” The size of the 2009 class, he went on, was “unplanned,” again referring to a surprise in yield.

But given that interest in graduate school typically spikes during economic slumps, wasn’t a sharp rise in yield foreseeable? It was to N.Y.L.S.’s rivals. There are about 40 other schools in what US News has long categorized as its third tier, and the average increase in class size at those schools in 2009 was just 6 percent. (At 10 of those schools, enrollment declined.) That is dwarfed by the 30 percent uptick at N.Y.L.S.

Whether Mr. Matasar had bond ratings in mind at the time, Moody’s liked what it saw. In August of 2010, the company issued a new report that included news of the 736-student class, which was described, in the classic understated style of bond reporting, as “particularly large.” The Moody’s outlook for the N.Y.L.S. bonds changed once again — this time from negative to stable.

THE incoming class of 2009 won’t hit the job market until next year, but if the experience of recent N.Y.L.S. graduates is an indication, many of them are in for a lengthy hunt. Mr. Matasar offered an inventory of N.Y.L.S.’s career services office, which he says includes 15 employees and provides development and mentoring programs and oversees a series of networking events.

There are those, he wrote, “who rave about the career services office.” But he added that a recent poll of law schools found that a little more than half of third-year students were unsatisfied with the job search help. “We have a similar experience,” he wrote.

Among the unsatisfied is Katherine Greenier, of N.Y.L.S.’s class of 2010. As she neared graduation, she organized an informational meeting for students interested in public-interest law, the kind of get-together she thought the career services office should have offered. To her amazement, a rep from that office showed up, took a seat and asked questions.

“She was asking about the process, like how you go about applying for public-interest fellowships,” Ms. Greenier says. “Things that you would have hoped she already knew.”

Ms. Greenier, who wound up with a job at the American Civil Liberties Union in Richmond, Va., ultimately decided that the school had what she called a “factory feel.”

The size of the incoming class of 2009 only sharpened that conclusion.

“There were people wondering, why did the school take on this many people in a job market this terrible?” she asked. “How many of these folks are going to find jobs? And what does it say about the school?”

IN April, Mr. Matasar stood in a lecture hall on the third floor at N.Y.L.S. and delivered the keynote at Future Ed, the third of three conferences about legal education that he’d helped organize, in partnership with Harvard Law School. A few dozen professors and deans were in attendance as he argued for a more student-centric approach to education.

“The focus shifts from us — we the faculty, we the administration, we the permanent employees of the school — to those we serve, our students,” he said. “Things are seen through a lens that says ‘What will this do for the students?’ ”

Nearly all the people who have worked with Mr. Matasar say he means what he says about reforming legal education. N.Y.L.S. professors recall meetings where he urged the faculty to be more responsive to students — to return calls faster, meet more often, whatever would help.

“He put a huge, beautiful student dining area in the top floor of that new building,” says Tanina Rostain, a former N.Y.L.S. professor, now at Georgetown University Law Center. “But it doesn’t have a faculty lounge. We were a little nonplussed, but it was clear that the students were Rick’s priority.”

How does one square that priority with the inexorable rise of N.Y.L.S.’s tuition, its population growth, its eyebrow-arching job data?

The question has puzzled more than a few academics and has produced a variety of theories. Perhaps the most compelling is that as both a crusader and a dean, Mr. Matasar has conflicting, even incompatible missions. The crusader thinks that law school costs too much. The dean has to raise the price of tuition or get murdered in the US News rankings. The crusader worries about the future of all those unemployed graduates. The dean has interest payments to make on a gorgeous new building.

“I’m 100 percent convinced that Matasar believes in his reformist agenda,” says Paul F. Campos, a professor at the University of Colorado at Boulder School of Law and a Future Ed attendee. “But all reformers discover that they can’t change a system by themselves. And by trying to survive in the current structure, he has ended up participating in the perpetuation of its most indefensible elements.”

The tale of Mr. Matasar’s career is not primarily about a gap between words and actions. Rather, it is a measure of how all-consuming competition in the legal academy has become, and how unlikely it is that the system will be reformed from within.

To be clear, there is little about the way N.Y.L.S. operates that is drastically different from other American law schools. What’s happened there is, for the most part, standard operating procedure. What sets N.Y.L.S. apart is that it is managed by a man who has criticized many of the standards and much of the procedure.

In fact, Mr. Matasar has been quoted about wanting to upend legal education for so long it is impossible to believe he is doesn’t mean it. But he can’t act unilaterally. And what industry has ever decided that for the good of its customers, it ought to charge less money, or shrink?

“My salary,” Mr. Campos said, “is paid by the current structure, which is in many ways deceptive and unjust to a point that verges on fraud. But as a law professor, I understand that what is good for me is that the structure stay the way it is.”

DECRYING a business and benefitting from it at the same time — it puts you in a tough spot, Mr. Campos said, and one he speculated is even tougher for a dean. But it is not a spot that Mr. Matasar will be in for much longer.

Several weeks ago, Mr. Matasar sent an e-mail to his faculty stating that he would step down in the next academic year. He was considering a few different job options, he explained, all of them “outside of legal education.”

Baltimore Sun

Read the UB dean's letter to the law school community

July 29, 2011

To the School of Law Community:

At a meeting at 4 o'clock on July 28, University President Robert Bogomolny asked for my resignation as Dean of the School of Law. As of today's date, I have resigned my position as Dean. I truly appreciate the support I have received from the faculty, staff, students and alumni of the School of Law. I write this decanal farewell in order to provide a brief explanation of why I am no longer Dean and to express my gratitude to all of you who welcomed me so warmly to Baltimore.

In the last two years, tensions have been increasing between the University administration and me regarding the financial relationship between the University and the School of Law. When I was a candidate for the Deanship, I was aware that, historically, the University retained a high percentage of the revenue generated by the law school. I was assured by the President at that time that he was aware of the problem and would work with me to remedy it over time. As I began my deanship, I realized that the law school did not possess accurate data in many areas, including its financial situation. Obtaining accurate financial data regarding the School of Law has not been an easy task. After much research and discussion, the University Finance Office and the School of Law agreed this past year on the amount of law school revenue generated by tuition, fees and state subsidy. I obviously always knew our School of Law budget. I have not yet received the critical data regarding the amount of direct and indirect University costs properly attributable to the School of Law. My insistence on having accurate data has exacerbated the difficulties between the University and me.

Every seven years, the ABA inspects law schools for renewal of their accreditation. The law faculty drafted a self study in the spring of 2010 as part of our ABA reinspection process. The percentage of law revenue retained by the University was emphasized as a significant concern of the faculty in that document. I believe a law school dean has a continuing responsibility to share accurate data regarding the law school and its operations. In the past year, I distributed the financial data I had to the faculty and the Dean's Advisory Board in order to inform them about the increasing scope of the problem. Both bodies were concerned about the continued ability of the law school to reach its potential without sufficient funding and the inequity of charging law students increasingly high tuition and fees if a significant percentage of those funds were not directly benefitting the law school. Both the faculty and the alumni insisted that I continue in my efforts to obtain more financial data and a University agreement to decrease its retention percentage over time. I was criticized by the central administration for sharing the financial data with the faculty and my advisory board. University officials also stated that providing funding for the continued improvement of the School of Law was not a high priority for the University.

The financial data demonstrates that the amount and percentage of the law school revenue retained by the University has increased, particularly over the last two years. For the most recent academic year (AY 10-11), our tuition increase generated $1,455,650 in additional revenue. Of that amount, the School of Law budget increased by only $80,774. I do not know of any law school in the country receiving such a small percentage of its generated tuition revenue. A recent article in The New York Times noted that a 25-30% revenue retention by a university was considered high by national standards. As of academic year 2010-11, the University retained approximately 45% of the revenue generated by law tuition, fees and state subsidy. Using any reasonable calculation of the direct and indirect University costs, the University was still diverting millions of dollars in law school revenue to non-law University functions.

Baltimore Sun

Read the letter from the UB president

August 01, 2011

To UB Law Faculty and Staff,

This e-mail is in response to the major issues raised in relation to the resignation of University of Baltimore School of Law Dean Philip Closius. I welcome the opportunity to clarify the misleading and incomplete characterization of the University's relationship to the School of Law that unfortunately resulted from Mr. Closius' public statements.

The decision to seek new leadership for the UB School of Law involved considerable thought around multiple issues during an extended period of time. The ultimate decision was not about financial matters. Although management of University finances was one area of conflict between Mr. Closius and the University, it was not the only area of conflict. I am unable to discuss confidential personnel matters, and unfortunately I cannot provide full details concerning this matter. I can assure you that, based upon many conversations during the past few months, including conversations the provost and I had with approximately a dozen senior law faculty members, select alumni and UB Foundation officials, the overwhelming conclusion was that a change in leadership was in the best interests of the School of Law and the University of Baltimore..

Mr. Closius raised a number of issues in his e-mail to law faculty, staff and students, which he also chose to release to the local and national press. I will address the major, substantive issues below. Please know that I welcome the opportunity to discuss these issues with the law faculty and staff to answer any questions that may remain.

University and Law School Finances

Mr. Closius' central complaint is that the University withheld 45 percent of the School of Law's revenue in the past academic year. In fact, in 2010, the year cited in the recent ABA site visit report, the University retained 13.7 percent of law revenue centrally, after allocating costs related to the law school's regular operation.

Using the 2010 data referenced in the ABA report, 42 percent of law school revenue was retained centrally in 2010 prior to the allocation of general operating costs. The law school's operating costs for 2010 – all expenses attributable to the School's operation that are routinely absorbed centrally, including those related to basic functions such as human resources, technology, heat, light, security, etc. – amounted to approximately $9.97 million. After these costs are allocated for 2010, the School of Law had 13.7 percent of its revenues retained centrally. UB's 13.7 percentage is well below the 20–25 percent national law school average cited in the School of Law's 2010 self-study report, is considerably below the 25–30 percent referenced by Mr. Closius from a recent New York Times article, and represents the lowest percentage among UB's schools and colleges.

Mr. Closius asserts that the UB administration did not provide accurate, transparent financial data regarding central University budgets and the law school allocation. All University budgets are matters of public record and are reported in the state's budget book. The University's internal budget process is open and participatory, with allocations published on the community's Web portal.

To address Mr. Closius' continued requests for budget clarification, I held an open meeting for law faculty early in the spring 2011 semester, accompanied by the provost and the senior vice president of Administration and Finance. At this meeting, I specifically stated that Mr. Closius' assertion that the University withheld more than 40 percent of the law school's revenue was incomplete and misleading because it did not take into account the School's indirect costs, expenses necessary to operate a law school.

Baltimore Sun

University of Baltimore president responds to ousted law dean

Bogomolny says change of leadership will serve best interest of law school, disputes Closius' budget facts

August 01, 2011|By Childs Walker, The Baltimore Sun

The University of Baltimore's president issued a sharp response Monday to allegations aired by the university's former law dean after he was forced to resign last week.

In an e-mail to faculty and staff, President Robert L. Bogomolny disputed financial arguments used by former dean Phillip Closius to portray a university taking advantage of its law school to support other programs. Bogomolny said he had met with key alumni and faculty members and that "the overwhelming conclusion was that a change in leadership was in the best interests of the School of Law and the University of Baltimore."

That message ran counter to an outpouring of criticism last week from students and alumni who praised Closius as a dynamic and caring leader. Students have planned an all-day rally on Tuesday to protest the dean's removal.

The president's e-mail continued an unusual bout of public sparring that has laid bare internal disputes at a university known for producing some of Baltimore's top attorneys. The debate touches on a broader issue in legal education, with law deans around the country claiming that their schools are exploited to support less popular programs.

In his e-mail, Bogomolny rejected the notion that that is occurring at UB and argued that Closius, whom he hired, was off base in saying the law school was not a funding priority.

"This stands in stark contrast to the facts of the School of Law's recent growth and development," Bogomolny wrote. "During my presidency, faculty has grown by more than 30 percent, while scholarships for law students have increased by more than 325 percent in the last five years alone."

He defended recent tuition increases, saying they were necessary to support "transformative growth."

The president disputed Closius' claim that the university seized 45 percent of law school revenues in 2010-2011. Instead, Bogomolny used figures from 2009-2010 to show that of the 42 percent of law school revenues taken by the university, all but 13.7 percent was used to pay for law school operations. The president said the figure represented the "lowest percentage among UB's schools and colleges."

Bogomolny said he held an open meeting with law faculty during the spring semester to dispute Closius' interpretation of the numbers.

"After this presentation, Mr. Closius continued to assert that there has been no rationale or explanation of internal allocations," the president wrote.

He said Closius' complaints led an accreditation panel from the American Bar Association to request a report on the university's budget rationale. "I look forward to submitting that report, as I am confident that it will address this issue definitively and satisfactorily," Bogomolny wrote.

Closius said Monday afternoon that he did not want to continue the back-and-forth with Bogomolny, but he defended his presentation of the numbers as consistent with the way the figures are discussed nationally. "I disagree," he said of Bogomolny's interpretation, "and I'm pretty sure I'm right."

Bogomolny's words did not allay the concerns of law professor Garrett Epps, who said he was "gob smacked" by Closius' forced resignation.

"We all know that every law school is something of a cash cow," Epps said. "As near as we can tell, the University of Baltimore is the biggest cash cow in the country."

Epps credited Closius with improving the quality of the school's students and junior faculty members during his four years as dean. "He had very deep support in the faculty," Epps said. "I am completely mystified by the abruptness of his resignation."

Asked about Bogomolny's statement that he had vetted the leadership change with select faculty leaders, Epps said, "He certainly didn't talk to me."

In his e-mail, Bogomolny also disputed Closius' version of a blow-up regarding naming rights for the law school. Closius said he had negotiated a deal for $10 million with local litigator and alumnus Stephen L. Snyder, only for Bogomolny to reject the deal and raise the price to $20 million. Snyder then declined to meet that price.

The president said he decided $10 million was "substantially inadequate" after reviewing the market for naming rights with university system officials and an outside consultant. He said his judgment was recently validated when the University of Maryland received $30 million from the W.P. Carey Foundation for naming rights at its law school.

Bogomolny concluded that the law school "continues to make considerable progress in terms of faculty quality and student success. … As we strengthen our leadership moving forward, I am confident that this momentum will continue."

According to the university and Closius, the former dean will be part of that future; he said Monday that he still plans to return as a regular faculty member after a yearlong sabbatical.

childs.walker@baltsun.com

Inside Higher Ed

Suing Over Jobs

August 11, 2011

For the last year, the Education Department and Congress have debated measures of "gainful employment" for graduates of for-profit vocational programs. And media outlets have competed for the best stories about unemployed liberal-arts graduates. But the question of whether higher education can be held responsible for failing to warn would-be students about the poor job prospects of graduates may really be taking off with regard to law schools.

On Wednesday, a New York City law firm filed class actions against two law schools -- New York Law School and Thomas M. Cooley Law School -- charging that the job placement information they released to potential students was sufficiently inaccurate as to constitute fraud. Those suits follow a similar one filed in May against Thomas Jefferson School of Law. All of the suits argue that students were essentially robbed of the ability to make good decisions about whether to pay tuition (and to take out student loans) by being forced to rely on incomplete and inaccurate job placement information. Specifically, the suits charge that the law schools in question (and many of their peers) mix together different kinds of employment (including jobs for which a J.D. is not needed) to inflate employment rates.

All three law schools deny the charges. And Cooley has already filed a defamation suit against the lawyers suing it. But the litigation comes amid a broader debate over whether the American Bar Association and others are doing enough to promote the release of accurate information, and whether there are too many law schools for the current job market.

While legal experts were still examining the lawsuits and were generally not ready to weigh in on whether or not they will succeed, several said that the litigation points to longstanding problems with how job placement has been tracked, and that changes currently under consideration are overdue.

"The fact that you have some serious class action law firms filing suit should give anybody pause," said William D. Henderson, a professor of law and director of the Center on the Global Legal Profession at Indiana University, and a frequent author on job placement issues. "The whole industry hasn't released useful numbers for consumers," he said.

Henderson said that he strongly backed current moves by the American Bar Association (likely to then be adopted by U.S. News & World Report for its rankings) to shift from a standard of being employed nine months after graduation to being employed in a job for which a J.D. is needed. Those suing today (and those in recent years who were disappointed by their success at finding jobs) relied on statistics that didn't exclude those whose "jobs" were fellowships paid for by their law schools, who were in part-time or temporary jobs, or who were in jobs they could have gotten before they went to law school, he said.

Several years ago, Henderson started noticing and writing about the seeming oddity that bar passage rates were declining at a time when law schools were reporting increases in employment of graduates. For this to be true, he speculated, more people were getting jobs that didn't require them to go to law school. "You are counting people who are selling insurance," he said. "Anybody can find a job to pay the rent."

The New Lawsuits

The new lawsuits are class actions on behalf of three graduates of New York Law School and four from Thomas Cooley. (Both are freestanding law schools.)

Jesse Strauss, one of the lawyers bringing the suits, said in a briefing for reporters Wednesday that he was not denigrating the quality of the legal education provided by the law schools, and that he knew good lawyers who were graduates of each institution. But he said that the information about job placement rates was deceptive. "This is more like a false advertising claim than a product liability claim," he said.

Strauss said that the deceptive information about job placement rates is "distorting the market." With better information, he said, some students wouldn't go to law school, and the population of new lawyers would shrink.

The lawsuit charges that the schools' methods of reporting their placement rates gave would-be students an inaccurate view of their likely outcomes.

"[T]he school during the class period claims that a substantial majority of its graduates -- roughly between 75 and 80 percent -- secure employment within nine months of graduation. However, the reality of the situation is that these seemingly robust numbers include any type of employment, including jobs that have absolutely nothing to do with the legal industry, do not require a J.D. degree or are temporary or part-time in nature," the suit against Thomas Cooley says. "Rather, if Thomas Cooley was to disclose the more pertinent employment statistic -- i.e., those graduates who have secured full-time, permanent positions for which a J.D. degree is required or preferred -- the numbers would drop dramatically, and could be well below 30 percent, if not even lower."

The suit against New York Law School states that it "blatantly manipulates" its placement statistics (which suggest that 92 percent of last year's class is employed). The suit says that the law school engages in numerous efforts to "pretty up" its statistics, such as including part-time work, and including the 5.6 percent of its employed graduates who are in temporary fellowships funded by the law school -- not in real jobs.

The law schools released statements that did not offer point-by-point rebuttals of the suits, but defended the integrity of their statistics. "To the extent the lawsuit challenges our post-graduation employment and salary statistics, we stand by our reporting to the National Association for Law Placement, and any claims that prospective students or our graduates have been misled or legally harmed by our reporting are simply baseless," said the statement from Thomas Cooley. (Even as the law school is being questioned over its job placement record, Thomas Cooley is expanding -- and this week announced plans to open a campus in Florida.)

A statement from New York Law School said: "These claims are without merit and we will vigorously defend against them in court."

The Broader Debate?

What's next in the debate over law placement and these legal cases is the subject of much debate. Officials from the ABA, the Association of American Law Schools and NALP: The Association for Legal Career Professionals did not respond to requests for comment on Wednesday. Privately, two law school officials expressed doubts about whether the class actions would succeed in court, but indicated that defending against them might be embarrassing for the law schools involved and for legal education generally.

For an example of the potential public relations challenges, consider the response of Thomas Jefferson to its class action. As reported in the blog Above the Law, Thomas Jefferson defended itself by noting that the U.S. News job placement figures on which the plaintiff relied were adjacent to figures in the magazine for the law school's bar passage rate. The law school's bar passage rate was lower and Thomas Jefferson's rate many years was "significantly lower" than the employment rate, the law school argues in its brief. So "any reasonable reader" would know that meaningful numbers of the law school's graduating classes were not working as lawyers. The blog's headline for the post: "Is the Answer Worse Than the Allegations?"

While the three law schools that have been sued are not among the nation's most prestigious, the lawyers who sued on Wednesday stressed that they saw the issue as going well beyond those institutions. At the news conference, they pointed to a recent article in The New Republic that analyzed data from an unnamed "top 50" law school, suggesting that one-third of graduates reporting themselves employed are in part-time positions -- meaning that well under half of graduates of a recent class are employed in full-time permanent positions, not the healthy majority that the official statistics would suggest.

Kyle McEntee, executive director of Law School Transparency, a group that has critiqued job placement rates at many law schools, said he was not surprised by the lawsuits. "I think we are going to see more of them," he said.

He said that the moves by the ABA are in the right direction, but that his group wants to see even more information. Law School Transparency urges law schools to release, graduate by graduate, exactly what happens to each new lawyer (without their names). That way prospective students won't get deceived by averages that may be skewed by a few well-compensated lawyers, and will be able to distinguish between true stepping-stone positions (judicial clerkships, for example) and volunteer work that doesn't put someone on the fast track.

Will the ABA Reforms Work?

The proposed ABA surveys on employment deal with many of the criticisms that have been made of past data. For instance, they would ask specifically about whether positions are funded by the law school, whether positions are long term or short term, etc.

But there is controversy over whether these efforts will work. NALP, which has been the primary source of law school placement data, has expressed fears that law schools will no longer collect data for its surveys, and that it is better able than the ABA to analyze the data. (A limitation of NALP's data is that they are not available institution-by-institution, which is why U.S. News's rankings, which include institutional data, have become so valued by law school applicants and so important to law schools.)

Henderson, of Indiana University, said that the ABA may unintentionally supplant NALP, and leave the law school world without anyone capable of truly analyzing the data. The ABA, he wrote in a recent column for The National Law Journal, "has a long track record of releasing mountains of data in a format that makes it very difficult to analyze the industry or make meaningful school-to-school comparisons."

With truly good data, he predicted, the law school market would change, with some law schools forced to improve their programs and with others disappearing.

But Henderson added that he's not certain that -- even with better data -- there won't be disappointed (and impoverished) law school grads in the years ahead. "You've got 22- and 23-year-olds who have an image of lawyers made by popular culture," he said. "They've never bought a house before, and now they can get a loan of over $100,000 to go to law school. This is not a group of people who are going to do rigorous due diligence on the decision to borrow."

— Scott Jaschik

Inside Higher Ed

Hostile Witness

August 9, 2011

These days there are enough blogs on the theme that law school is a scam that there are multiple blogrolls on the subject, where readers can pick among First Tier Toilet!, Fluster Cucked, Subprime JD, Tales of a Fourth-Tier Nothing and more. Most of these blogs are run by law students or recent graduates frustrated by a lousy job market, student loan debt and a feeling that they were ripped off by their law schools.

Another unemployed lawyer blog probably wouldn't attract much attention, but these "scam" bloggers have been abuzz about the latest arrival on their blogrolls: a blog sharing many of their points of view, but written by a tenured law professor.

"I can no longer ignore that, for a very large proportion of my students, law school has become something very much like a scam," says the introductory post of the blog, Inside the Law School Scam. "Yet there is no such thing as a 'law school' that scams its students -- law schools are abstract social institutions, not concrete moral agents. When people say 'law school is a scam,' what that really means, at the level of actual moral responsibility, is that law professors are scamming their students."

The professor has gone on in subsequent posts to describe his law faculty colleagues as overpaid, and as inadequate teachers. "The typical professor teaches the same classes year after year. Not only that -- he uses the same materials year after year. I’m not going to bother to count -- this is law school after all, and we don’t do empirical research -- but I bet that more than half the cases I teach in my required first-year course were cases I first read as a 1L 25 years ago. After all I use the same casebook my professor used. I even repeat some of his better jokes (thanks Bill)," says one post.

And that was followed by another criticizing the gradual decline in teaching loads of professors at law schools (a trend that has been documented elsewhere), and arguing that students are paying quite a bit for minimal teaching time and effort. Of his fellow law professors, he writes: "They are like the most burnt out teachers at your high school, if you went, as I did, to a middling-quality public school. But with this difference: the most burnt-out teachers at your high school still had to show up for work for seven hours a day. Also, they didn't get paid $200,000 (or even quite a bit more) per year. And you didn't pay $50,000 a year for the benefit of their talents."

And LawProf says he's just getting started.

The author identifies himself only as "a tenured mid-career faculty member at a Tier One school." He agreed to reveal his identity to Inside Higher Ed, and his description is accurate. He teaches at a law school that doesn't make the "top 10" lists, but that is generally considered the best in its state and is well regarded nationally. His C.V. shows plenty of scholarship and professional involvement. And while "LawProf" (as he calls himself) is disdainful of the prestige hierarchy of American law schools, he said in the interview that it was important for the law school world to hear from someone "at a better law school," because so many law professors write off the current complaints from new graduates "as the concerns of third-tier law schools, which don't matter."

The reality, LawProf said, is that while students at top law schools fare much better, the issues are present everywhere. "Students are unable to get the kinds of jobs they want, and they are having to go for jobs they didn't envision before, and they are feeling ripped off," he said.

"A lot of people are going to get mad at me," especially if they ever figure out who he is, which he expects will happen, LawProf said. And while he has tenure, he said he believed there would be repercussions for speaking out as he is. "It's breaking a wall of silence," LawProf said. And he said that he believes he will be more frank by writing anonymously.

In terms of reforming legal education, LawProf said it could be much less expensive, which in turn would result in less of a need for students to borrow, and change the current dynamic in which new graduates face massive debts without good jobs.

A plan for change, he said, would be to ignore the rankings (which encourage the wrong kinds of behavior), to stop spending so much on "luxury" facilities for law schools "that have nothing to do with education," to cut the number of administrators, and to offer fewer legal clinics (which he said are expensive and hide the poor job law schools do of training people to be lawyers).

And in a reflection of how unpopular he would be with his colleagues if he went public, LawProf called for law professors to be paid much, much less. Law professors (along with those in fields such as medicine and business) typically earn much more than their faculty colleagues in other disciplines. LawProf said he earned about $170,000 last year -- nowhere near the top of the heap at his law school, but double what most tenured professors outside the law school earn at his institution.

The traditional argument made in defense of such salary levels is that law schools would lose their best talent to law firms. But LawProf said that was "a bunch of bullshit." He said that law schools regularly employ a limited number of top lawyers (at a fraction of their billable hour rates) to teach single courses, and could do more of this and thereby bring more real-world experience into law schools.

And as for the full-time academics, LawProf said that they enjoy benefits of not working in law firms: shorter hours, less pressure, the ability to pick their areas of interest -- all of which should make typical academic salaries appropriate. Law professors, he said, do things they like 95 percent of the time, and law firm lawyers do that 5 percent of the time. That is a choice of value, he said. "Why are we paying these academics twice as much as other academics?" he asked.

Michael A. Olivas, a law professor at the University of Houston who is president of the Association of American Law Schools (but who stressed that he was speaking for himself, not the organization), said that LawProf is welcome to return half of his salary if he is guilt-ridden.

Olivas said that "there is a small grain of truth in most of what he says," but that his portrayal of law professors is unfair and inaccurate. Olivas said that good law professors prepare for every meeting of every course, paying attention to changes in the law. He said that they routinely help not only current students, but alumni. And he said legal scholarship is valuable to academe and society. "It's unprincipled to walk into class unprepared," he said. "I would never do that. Most people would never do that."

The vision of law school presented by LawProf neglects the extent to which American legal education is seen as a model in the rest of the world, Olivas said. Models that are based on maximum efficiency in other countries lead to large classes, minimal professor-student contact, and no scholarship, he added, wondering whether LawProf would like such a set-up in the United States.

Olivas also criticized LawProf for writing anonymously. "To hide behind an anonymous blog is to create hearsay that doesn't even round up to gossip," he said. Making such criticisms in public, Olivas said, would create an opportunity for meaningful debate, including exploring whether LawProf's experiences at his law school are typical of the faculty members there, or of law professors in general.

LawProf said that the realities of legal education today require a "whistle-blowing approach" such as the one he is taking. Other professions -- such as medicine -- may be guilty of restricting entry and making training quite expensive, but they tend to produce solid careers for those who graduate from medical school. "The cartel of legal education is not good at all at protecting law graduates, but it's very good at protecting the economic privileges of legal academia," he said. The reason he has joined the "scam bloggers" is that "they have figured out that we have a cartel that screws them and the public."

— Scott Jaschik

President Obama promised that Americans who like their current coverage can keep it on more than 45 separate occasions. However, according to Department of Health and Human Services’ (HHS) 2010 rule on grandfathered health plans under the Patient Protection and Affordable Care Act (PPACA), between 39 and 69 percent of businesses will lose their status as “grandfathered health plans.” The picture is even worse for small businesses – HHS estimates by 2013, up to 80 percent of small businesses will lose their grandfather status.

Unfortunately, an accumulating mountain of evidence paints an even more dire picture. Two former Democrat Governors have predicted employers will drop health coverage. Former Tennessee Governor Phil Bredesen wrote in the Wall Street Journal about the incentives for the state of Tennessee to drop state employee insurance. According to Governor Bredesen, Tennessee could pay the $2,000 dollar fine on each employee not covered, give cash raises, and still come out $146 million ahead.

Click here to keep reading...

Dr. Coburn, along with Sens. Ron Johnson (R-WI), Claire McCaskill (D-MO), John McCain (R-AZ), and Scott Brown (R-MA), today sent this letter to the members of the Senate Committee on Appropriations concerning the budget of the nonpartisan Government Accountability Office (GAO) being subjected to unfair and excessive cuts. While they agree GAO must face the same harsh fiscal realities being applied to every other federal agency and program, the cut to the agency’s budget represents more than ten percent of the entire reduction proposed within legislative branch spending.

Excerpts:

• "We are concerned that the Government Accountability Office (GAO) is being unfairly singled out with both excessively deep cuts and overly burdensome new mandates that will consume the agency’s more limited resources for no apparent benefit"

• "While GAO’s budget is being slashed, the bill provides a spending increase for the John C. Stennis Center for Public Service Training and Development and Senators Official Personnel and Office Expenses escape serious cuts with a shave of just 3.17 percent"

• "While GAO has stepped up efforts to meet congressional demands, the oversight conducted by Congress itself has declined dramatically. Congressional committees, for example, held 318 fewer hearings in the 111th Congress than in the 110th Congress. There is no question oversight of the federal government, a primary function of the legislative branch, will suffer as a result of this dramatic cut to GAO funding"

• "As we seek solutions to our nation’s fiscal crisis, GAO’s nonpartisan expertise has never been more valuable. In fiscal year 2009, GAO documented about $43 billion in financial benefits—a return of $80 for every dollar spent by GAO. The $41.7 million cut to GAO’s budget could, therefore, result in $3.3 billion in federal funds that will be lost to waste, fraud, abuse, and inefficiency. We cannot afford that possibility, especially at this time"

Full text of the letter: here

Senators DeMint, Coburn, Lee, and Johnson urge their colleagues to address concerns related to the Combating Autism Reauthorization Act and request modifications to the bill that would prioritize taxpayer dollars by ending programs that the Government Accountability Office has shown to be wasteful, duplicative, and inefficient. 

Read the letter from Senators DeMint, Lee, Coburn, and Johnson to Senator Menendez here. Text of their amendment to provide the Secretary with discretion to conduct the programs reauthorized under the Combating Autism Reauthorization Act using existing funds here.

Today,  Dr. Coburn urged Majority Leader Reid to include his amendment that would repeal the federal mandate that requires states to spend 10 percent of funding provided from the surface transportation program (STP) for transportation enhancement (TE) activities.  TE includes transportation museums, pedestrian walkways, bicycle paths, landscaping and scenic beautification, and has even included a squirrel sanctuary and a turtle tunnel.

If states do not comply with this federal mandate, the federal government “will withhold future” STP funding from states not in compliance with this mandate.

 This amendment repeals the federal mandate forcing states to spend 10 percent of STP funds on niceties rather than transportation needs.  This will provide states and communities the flexibility to enhance safety rather than beautification and to meet local needs rather than the whims of Washington politicians, bureaucrats and special interest groups. 

Additional background on the amendment: here.

Claim: “They pay for this benefit during their working years. They earn it.”

Fact: Actually, current taxpayers, not the seniors who contributed during their working years, are primarily paying for Medicare benefits. A single woman who retired in 1980, after earning average wages throughout her career, could expect to receive medical care worth about $74,800 over the rest of her lifetime. A comparable woman retiring in 2010 can expect services worth $181,000 (adjusted for inflation). These estimates, by economists Eugene Steuerle and Stephanie Rennane of the Urban Institute, illustrate the huge disconnect between widely-held perceptions and the numbers behind Medicare's shaky financing. Consider an average two-earner couple who together earn $89,000 a year. Upon retiring in 2011, they would have paid $114,000 in Medicare payroll taxes during their careers. But they can expect to receive medical services – from prescriptions to hospital care – worth $355,000, or about three times what they paid into the program during their career.

—

Claim: “But with an aging population and rising health care costs, we are spending too fast to sustain the program.”

Fact: This is true, but other factors are also at work. When Medicare was created in 1965, the average life expectancy was just above 70 years old. At that time, roughly 4.6 workers supporting each beneficiary receiving benefits. However, because of improvements in medical innovation and public health, today life expectancy is above 80 years old, and there are an average of 3.8 workers per beneficiary. With current trends and a wave of retiring baby boomers, in 2050 the program is only expected to have about 2.2 workers per beneficiary.

—

Claim: “If we don’t gradually reform the system while protecting current beneficiaries, it won’t be there when future retirees need it.

Fact: Actually, current retirees who depend on Medicare are already threatened by a broken Medicare system. The 2011 report of the Medicare Board of Trustees estimates that under a best-case scenario, by the time a 65-year-old today is 78, the program will be insolvent. Troublingly however, the program’s actuary recently said that in a worst-case scenario, Medicare’s hospital insurance program could be exhausted in 2016.

—

Claim: “We have to reform Medicare to strengthen it.

Fact: Yes, one thing that Democrats and Republicans should be able to agree on: we have to reform Medicare to strengthen and save it. It’s not a matter of personal opinion, it’s basic math. The nonpartisan CBO estimates that the program is just nine years away (2020) from not being able to pay out current benefits. The Medicare Actuary’s official estimate of the date of insolvency is 2024, though a more realistic assessment from the Actuary’s office suggests the program could be insolvent as soon as 2016.

# # #

Dr. Coburn's amendment #599 to H.R. 1249, the Patent Reform bill would provide an immediate solution to the financial crisis at the Patent & Trademark Office (PTO). The amendment creates a lockbox—a new revolving fund at the Treasury—where user fees that are paid to the PTO for a patent or a trademark go directly into the revolving fund for the PTO to use to cover its operating expenses. Congress would not have the ability to take those fees and divert them to other general revenue purposes.

Coburn amendment #599 bill text here. Additional background here. 

Dr. Coburn's op-ed on ending patent fee diversion here.

While members of Congress have at times been accused of receiving excessive retirement payments while being exempt from contributing to Social Security and the congressional pension fund themselves, this is not in fact true.

A report by the non-partisan Congressional Research Service provides a summary of why, contrary to popular belief, members of Congress are currently required to participate in Social Security and have been since January 1984.

Key facts about retirement benefits for Members of Congress:

• Members of Congress first elected in 1984 or later are covered automatically under the Federal Employees' Retirement System (FERS) and required to participate in Social Security.
• Members of Congress also have the option of participating in the Thrift Savings Plan (TSP) which is akin to a 401K plan.
• Congressional pensions are financed through a combination of employee and employer contributions, this includes Members of Congress.
• The amount of the congressional pension depends on years of service and the average of the highest three years of salary. By law, the starting amount of a Member's retirement annuity may not exceed 80% of his or her final salary.

Read the full CRS report here.

On July 29, 2011, a committee of the Institute of Medicine (IOM) released its report reviewing the FDA’s 510(k) process for approving medical devices. The FDA spent $1.3 million taxpayer dollars tasking the IOM committee to answer two basic questions. However, based on a review of the IOM committee’s membership, process, and funding, it is not at all clear if taxpayers were well served by the report.

Membership

• The membership of the IOM Committee was quite distinguished, but according to the FDA’s response to questions for the record before the House Energy and Commerce Committee, “no member of the committee [was] an entrepreneur or an investment capitalist,” and “no member of the committee [was] employed or otherwise works with a patient advocacy group related to medical devices.” Furthermore, it is not clear how many, if any, of the physician members of the panel currently practice medicine and use medical devices in a clinical practice. It would have been more prudent to include individuals with direct experience in the industry and process being evaluated. Omissions to the contrary are an unfortunate oversight.

Process

• It is not entirely clear that the IOM process was sufficiently through in a manner that engaged the necessary stakeholders. In response to questions for the record before the House Energy and Commerce Committee, the FDA noted that the IOM committee only held three public meetings – a public meeting and two public workshops – to discuss an issue of such great significance to patients and industry.

• The FDA tasked the IOM Committee to answer two basic questions:

1. Does the current 510(k) process protect patients optimally and promote innovation in support of public health?

2. If not, what legislative, regulatory, or administrative changes are recommended to achieve the goals of the 510(k) process optimally

• However, despite this important and simple charge, the IOM Committee largely punted on answering these questions in specificity. The committee recommended effectively scrapping the entire 510(k) process – a process that has been relatively widely praised by patients, consumers, innovators, and manufacturers.

• If committee’s report were merely the product of a private entity, it would be disappointing, but less concerning. However, the IOM committee’s methodology and results not only may have wasted $1.3 million taxpayer dollars, but points to a larger troubling trend.

Funding

• An examination of the data reveals that taxpayers may be disproportionately subsidizing the IOM.

• Based on a review of IOM’s federal funding from FY2001 through FY2011, taxpayers gave IOM $307.2 million over that timeframe.

• This is not only a lot of money, but it appears that, at least in some years, taxpayers funded more than half of IOM’s entire budget. For example, funding levels for 2009 are available in the "President’s Report Supplement Program Listing and View of IOM Finances, 2009 Edition." According to that report, “the program budget of the IOM in 2009 grew by more than 19 percent over the previous year. The trend toward an increasing fraction of support from non-government sources continued this year, with more than 40 percent of our total program budget in 2009 derived from private sources....” So was the remaining 60% was governmental? Yes, that’s roughly accurate. Page 53 of the report supplement has a figure showing that 55% of IOM program funding came from federal sources. The 55% is broken down as follows:

Conclusion

• While many well-intended professionals may make important contributions to their respective fields through work at IOM, in this case, based on a review of the IOM committee’s membership, process, and funding, it concerning that $1.3 million taxpayer dollars were spent on the IOM reviewing the FDA’s 510(k) process.

• There are further concerns that many of IOM’s taxpayer-funded projects and reports duplicate the capabilities of other organizations in and outside of government. For example, virtually all Departments within the federal government have employees who serve as policy analysts, budget crunchers, and issue experts that could be utilized in-house to produce reports or conduct research, at no extra cost to taxpayers.

• There are many intellectually interesting questions in life, and some are truly scientifically significant, but important questions deserve a rigorous, careful, transparent, and accountable process to produce constructive, concrete, and detailed answers for all Americans. Certainly in this case, Americans are right to ask if they got their money's worth.

Washington Journal host Susan Swain interviewed Dr. Coburn this morning about the latest debt limit negotiations and various proposals to put our nation's economy back on a sustainable course. 

Highlights..

“We have seen the Republicans offering multiple things. We have a bill on the senate they are going to table that actually fixes the problem, raises the debt limit, and they don't want to vote on it, so we're going to table it. So I think it is all political posturing”

“The root for us, as every American, is if we don't get a deal done, I think it will cost us a half of one percent. Even if we got a deal done 10 days later, I think it costs us a half of one percent. The problem isn't the negotiation between the republicans and democrats, it is not between the president and the speaker. The problem is for us to maintain our debt rating we have to have a program that cuts about $4 trillion at a minimum over the next 10 years”

“Washington doesn't cut because Washington cares more about being re-elected than they do about the public. It comes from a lack of courage to stand up and do the best right thing for our country”

“I would rather fix our country and lose a battle with Grover Norquist then send our country down the tubes and raise a point of view that is suicide”

“I think there are tons of tax credits and things in the tax codes that are unfair that we ought to eliminate. Anybody that gets something out of the tax code today in terms of the tax credit and the tax spend tour, you are paying for it if you didn't get one”

“We have to get $4 trillion. That doesn't go away no matter what anybody says. The President didn't have a deficit plan. The President's commission had a deficit plan. He never embraced it”

Today, Dr. Coburn filed amendment #500 to S.679, the Nominations Process Reform Bill that would require all legislation to be reviewed before it is considered by the Senate to determine whether new duplicative and overlapping programs are being created. 

Specifically, this amendment would require committee reports accompanying every bill to provide:

(1) an analysis by the Congressional Research Service to determine if the bill creates any new federal program, office, or initiative that would duplicate or overlap any existing federal program, office, or initiative with similar mission, purpose, goals, or activities along with a listing of all of the overlapping or duplicative federal program or programs, office or offices, or initiative or initiatives; and 

(2) an explanation provided by the committee as to why the creation of each new program, office, or initiative is necessary if a similar program or programs, office or offices, or initiative or initiatives already exist.

Text of the amendment HERE. Additional background HERE.

Today, the Council for Citizens Against Government Waste (CCAGW) and Americans For Prosperity offered their endorsement of the Medicaid Improvement and State Empowerment Act (S. 1031), urging Congress to pass this legislation that frees states from bureaucratic red tape and empowers them to make immediate reforms that will improve care for patients. CCAGW letter here. AFP letter here.

"Coburn’s S. 1031 introduces even better incentives, from which all states and taxpayers will benefit. It gives states more control over their program dollars to get rid of waste, fraud and abuse...It is long past time to introduce similar reforms to Medicaid. The current stalemate on the debt limit should not prevent Congress from taking up S. 1031 at the earliest convenience" - The San Francisco Examiner

"Their “Medicaid Improvement and State Empowerment Act” would give “health grants” to states to provide coverage for low-income Americans and give states more flexibility to provide care that suits the needs and resources of their states and not the dictates of Washington bureaucrats" - Daily Caller

"Rather than increasing Medicaid spending dramatically...Republicans have proposed giving states a specified amount of federal Medicaid funding that they could then use to tailor their Medicaid programs to the specific needs of their residents — something that governors have long been requesting" - The Weekly Standard

Last week, the Congressional Research Service (CRS) released data requested by Dr. Coburn on presidential appointments and nominations during the 111th and 112th Congress to date.

Specifically, the report found that of the 118 nominees awaiting confirmation as of May 6, 2011, only 87 were in just three committees Foreign Relations, Judiciary, and Health, Education, Labor, and Pensions. During the 111th Congress, the President submitted 964 distinct nominations to executive branch positions and as of May 6, he submitted 174 nominations to executive branch positions in the 112th Congress.

Read the full report here.

Today the Medicare Trustees released their annual report on the health of the Medicare program. The headlines will probably be filled with the news that report says that Medicare’s Hospital Insurance (HI) Trust Fund is now projected to be insolvent in 2024, which is five years sooner than the 2029 estimate in last year’s report. This is an important piece of the story, but don’t miss the key caveats offered by Medicare’s Chief Actuary on the very last page (p. 265) of the report, under “Statement of Actuarial Opinion.” A summary is below.

These “Projections” Are “Not Reasonable As An Indication of Actual Future Costs.”

• “While the Part B projections in this report are reasonable in their portrayal of future costs under current law, they are not reasonable as an indication of actual future costs. Current law would require a physician fee reduction of an estimated 29.4 percent on January 1, 2012—an implausible expectation.” The Congressional Budget Office has estimated maintaining the current level of physician reimbursements under Part B will cost taxpayers roughly $300 B.”

The Budget Gimmicks in Congress’ Controversial Health Law Anticipate Medicare Prices Will Be “Considerably Below” Current Medicaid Prices, “Far Below” Private Insurance Levels.

• “Further, while the Affordable Care Act ….there is a strong likelihood that certain of these changes will not be viable in the long range. Specifically, the annual price updates for most categories of non-physician health services will be adjusted downward each year by the growth in economy-wide productivity. The best available evidence indicates that most health care providers cannot improve their productivity to this degree—or even approach such a level—as a result of the labor-intensive nature of these services. Without major changes in health care delivery systems, the prices paid by Medicare for health services are very likely to fall increasingly short of the costs of providing these services. By the end of the long-range projection period, Medicare prices for hospital, skilled nursing facility, home health, hospice, ambulatory surgical center, diagnostic laboratory, and many other services would be less than half of their level under the prior law. Medicare prices would be considerably below the current relative level of Medicaid prices, which have already led to access problems for Medicaid enrollees, and far below the levels paid by private health insurance.”

These Budget Gimmicks Mean Congress Will Have to Spend More To Prevent “Severe Problems With Beneficiary Access to Care,” Which “Would Lead to Far Higher Costs for Medicare.”

• “Well before that point, Congress would have to intervene to prevent the withdrawal of providers from the Medicare market and the severe problems with beneficiary access to care that would result. Overriding the productivity adjustments, as Congress has done repeatedly in the case of physician payment rates, would lead to far higher costs for Medicare in the long range than those projected under current law.”

This Report Is Not a “Reasonable Expectation for Actual Program Operations” in the Short or Long Term.

• “For these reasons, the financial projections shown in this report for Medicare do not represent a reasonable expectation for actual program operations in either the short range (as a result of the unsustainable reductions in physician payment rates) or the long range (because of the strong likelihood that the statutory reductions in price updates for most categories of Medicare provider services will not be viable).”

Medicare’s Chief Actuary Gives Americans Recommended Reading for Medicare, Since Current Projections are “Poor Indicators” of the “Likely Future Financial Status of Medicare.”

• “I encourage readers to review the “illustrative alternative” projections that are based on more sustainable assumptions for physician and other Medicare price updates. These projections are available at http://www.cms.gov/ActuarialStudies/Downloads/2011TRAlternativeScenario.pdf. The Board of Trustees has convened an independent panel of expert actuaries and economists to consider these issues further and to make recommendations to the Board regarding the most appropriate long range growth assumptions for Medicare projections. To date the panel has concluded that the long-range Medicare cost growth assumptions underlying the projections in the 2010 Trustees Report (and used again in this year’s report) are not unreasonable. The panel further recommended continued use of a supplemental analysis, such as the illustrative alternative projections, for the purpose of illustrating the higher Medicare costs that would result if the physician payment reductions continued to be overridden by Congress and the productivity adjustments to most other provider payment updates were phased out. The panel’s ongoing work should help both to inform the selection of assumptions for the 2012 and later reports and to assess the sustainability of the Medicare price adjustments under current law. Although the current-law projections are poor indicators of the likely future financial status of Medicare, they serve the useful purpose of illustrating the exceptional improvement that would result if viable means can be found to permanently slow the growth in health care expenditures.”

Congress’ Controversial “Health Reform” Was Not Entitlement Reform.

• “The projections in this year’s annual report provide an unequivocal incentive to vigorously pursue the development of effective and sustainable new approaches, with the potential to make quality health care much more affordable.”

If the Economy Continues to Be Soft, Insolvency Could Occur Even Sooner.

• “Finally, the economic outlook remains more uncertain than usual. Due to the sensitivity of HI trust fund operations to wage increases and unemployment, the current slow recovery from the recent recession adds a significant further element of uncertainty to thetrust fund projections.”

Dr. Coburn is proposing to cut spending by $20 billion as the Senate debates the small business bill. He has filed the following eight amendments to S. 493 and looks forward to their adoption. Targets include ethanol, funding for PBS and duplications identified by GAO.

1. Eliminate funding for the ethanol subsidy: $4 billion. Background here (Amendment #220)

2. Eliminate funds for leftover earmarks: $4.8 billion. Background here (Amendment #218)

3. Eliminate program duplications identified by GAO: $5 billion. Background here (Amendment #273)

4. Eliminate unemployment payments to millionaires: $20 million. Background here (Amendment #281)

5. Reduce new car purchases by the government: $900 million. Background here (Amendment #221)

6. Eliminate funds for ‘covered bridges’ program: $8.5 million. Background here (Amendment #217)

7. Eliminate taxpayer subsidies for CPB: $550 million. Background here (Amendment #222)

8. Identifies, discloses, and describes every federal program. (Amendment #184)

9. Prohibits federal funds from being used to pay off TARP obligations. Background here (Amendment #279)

March 24th - the Council for Citizens Against Government Waste President Thomas Schatz sent a letter of support for S. 520, the Volumetric Ethanol Excise Tax Credit (VEETC) Repeal Act, a bill recently introduced by Senators Coburn and Cardin that would eliminate the $6 billion provided annually to subsidize blenders of ethanol. Read the letter from CCAGW here.

March 29th - Taxpayers for Commonsense circulated a letter urging members of Congress to support the Coburn-Cardin amendment to eliminate the ethanol tax credit and save taxpayers $6 billion in this year alone. Read the letter from Taxpayers for Commonsense here.

March 30th - President of the National Petrochemical and Refiners Association (NPRA), Charles Drevna, sent a letter of support for the Coburn-Cardin bill (S. 520) and the Coburn amendment (#220) to end the ethanol tax credit. Read the letter from NPRA here.

Congress’ controversial health care overhaul created the Independent Payment Advisory Board (IPAB) –a panel of unelected bureaucrats who will be politically-appointed and charged with developing proposals to "reduce the per capita rate of growth in Medicare spending." Under the law, HHS is forced to implement the panel’s proposals automatically unless Congress intervenes with similar cuts.

There are virtually no checks on the panel, since its members are not answerable to voters and its recommendations cannot be challenged in court. Because the panel is barred from examining common-sense changes like Medicare beneficiary premiums, cost-sharing, or benefit design, many expect that in efforts to control spending, the panel will limit patient access to medical care.

While the law does not provide a date by which the panel of bureaucrats will begin its operations, funding for the Board is authorized as soon as this fall (FY2012). Medicare’s Chief Actuary makes its first determination in 2013 which could set up the trigger and the panel’s recommendations.

Now there is troubling new news: the White House could bypass Congress and its role to confirm members by recess appointing members of this highly controversial panel. When nonpartisan experts at the Congressional Research Service were asked if it is possible for the President to recess appoint a working majority of the IPAB that are only of his political party, and then for those appointees to begin issuing recommendations, they confirmed it was possible. “We do not see why,” CRS staff said, “should the normal conditions for a recess appointment occur, the President could not recess appoint a majority of the 15-member Board with individuals of his choosing as long as those appointments complied with the other limitations established that section — that is, that the appointments include doctors and other health care professionals, that a majority of the board be non-providers, etc.”

This means the White House could nominate political allies, bypass the Senate’s constitutional role to confirm Presidential appointees, and effectively dictate policies through unelected Medicare czars. Since this Administration has already recess-appointed the highly controversial Don Berwick, what’s to stop the White House from pursuing this path?

Key excerpts from the report:

Could the President appoint members of the IPAB using his recess appointment authority?

• “There is no constitutional or statutory qualification on the President’s ‘Power to fill up all Vacancies ....’ Because the President’s recess appointment authority is unqualified, it appears that he could fill member positions on the IPAB by recess appointment during any period when he could otherwise make such appointments.”

If so, could he recess appoint enough members of his own political party to give the board a working majority without appointing any members of a party other than his own?

• “Were the President to make recess appointments to the IPAB, he could fill whichever positions on the board he chose to, consistent with the statutory requirements described above with regard to consultation, qualifications, and term specifications. He need not ensure that the result of his appointments is a politically balanced board. It is possible that he could, in fact, make recess appointments only to those membership slots that are likely to be filled by members of his own party: the three filled in consultation with the Senate majority leader, the three filled in consultation with the House minority leader, and the three filled without consultation. If the President were to make such recess appointments, 9 of the 15 member positions would be filled, and this number would be, as noted above, sufficient to provide a quorum for the board to conduct business. In addition, he could use his recess appointment power to appoint one of these nine members as chair. Inasmuch as the chair is empowered to ‘exercise all of the executive and administrative functions of the Board,’ this act would facilitate the managerial activities, such as the hiring of personnel and expenditure of funds, that would be necessary to start up the agency.”

What authority does the President have to remove IPAB members?

• “Regarding grounds for removal, it should be noted that there is no clear standard clarifying these statutory terms. Congress has stated, however, that a removal for good cause must be based on ‘some type of misconduct,’ as opposed to the refusal to carry out a presidential order….. As a matter of tradition and case law, members of other regulatory and quasijudicial boards and commissions are generally thought to enjoy protection from removal, even where the enabling statute is silent on such matters.”

Read the full report here.

Ads to Educate Seniors About Medicare Fraud: $165,000. HHS has announced a national media campaign to target Medicare fraud. This television and radio campaign is meant to educate consumers, specifically seniors, about fraud. It will emphasize the importance of protecting sensitive personal information (like Medicare ID numbers). It will run nationally, but focus on the fraud “hot spots” around the country. Specifically, the Administration on Aging has contracted to develop Public Service Announcements (PSA) to increase awareness of the Senior Medicare Patrols (SMP) fraud prevention message and provide a "call to action" for seniors to help fight fraud by becoming an SMP volunteer. The contract, for $165K, includes development of 60,30 and 15 second PSAs in Spanish and English for both radio and TV, development of a media campaign toolkit and distribution of PSAs to media outlets nationwide.

Ads to Persuade Seniors About PPACA’s $530 Billion Medicare Cuts: $700,000+. In responding to a letter from Sens. Coburn, Barrasso, McCain and Thune on HHS’s controversial ads about Medicare featuring Andy Griffith, Secretary Sebelius submitted information from CMS that said the Administration spent at least $700,000 “to produce and run [the] first spot of the open enrollment campaign” that featured Andy Griffith. A second letter from Secretary Sebelius (attached) further outlined the full costs.

March 10, 2011

Dear Secretary Sebelius:

As Chairman of the House Committee on Ways and Means Subcommittee on Oversight and Ranking Member of the Senate Permanent Subcommittee on Investigations, we write to express our concerns regarding the findings of Ernst & Young’s recent independent audit of the Department of Health and Human Services (HHS or Department) FY 2010 financial statements. This audit, contracted through the HHS Office of Inspector General, revealed significant and worrying shortcomings throughout your Department. We are deeply troubled by shortcomings that point to apparent mishandling of taxpayer dollars and seek to better understand what the Department is doing to correct the identified problems.

At a time of unprecedented departmental spending and additional responsibilities under the Stimulus and Democrats’ controversial health care overhaul, the audit suggests that the Department’s internal financial controls are in disarray. Despite federal laws requiring HHS to establish an integrated financial management system, the Department’s “accounting systems lack integration and do not conform to the requirements” of the Federal Financial Management Improvement Act, according to Ernst & Young. To remedy this lack of compliance, the Department has reportedly purchased a “commercial web-based off-the-shelf product,” though it is not expected to be fully integrated until as late as 2013.

The specific areas in need of improvement are too numerous to list here, but the following illustrative examples are particularly concerning:

• Nearly $2 Billion Taxpayer Dollars in Limbo: As of September 30, 2010, the audit found approximately 102,500 transactions representing “travel, grants, and contracts awaiting close-out,” totaling $1.8 billion that were open without any activity for more than two years. These represent transactions where the Department is owed or owes money but no action has taken place to close the transaction since the end of 2008. The audit also noted 1,750 grants totaling $165 million that have remained open since FY 2004.

• $794 Million in Mystery Money: Accurate budgetary monitoring is essential to the identification of cost overruns and material budgetary misstatements. As the auditors compared balances in HHS Budget Accounts to their related proprietary accounts, the audit found differences of $794 million “that could not be explained.”

• An Additional $400 Million in Mystery Money: Federal entities are required to reconcile their financial records with the Department of the Treasury (Treasury) on a monthly basis. Failing to do so can lead to inaccurate financial reports and undetected fraud. Because of a failure to comply with Treasury regulations, and a backlog of financial records dating back to 2004, HHS’s records differed with Treasury’s by an initial amount of $3 billion. Through additional work performed during the audit timeframe, this backlog was reduced to $400 million, which remains a very concerning amount.

• HHS Processes Date Back to 1980’s, Calling Into Question HHS’s Ability to Effectively Implement Current Law: A number of policies and procedures, including accounting practices, have “not been updated since the mid-1980s.” The audit noted that “the implementation of the [health care overhaul]… will have significant impacts with financial activity totaling in the billions to the Department over the next several years,” and additional financial systems training and procedure updating will be necessary to ensure correct accounting of these programs.

• Centers for Medicare & Medicaid Services (CMS) Data Vulnerable to Improper Access: Auditors identified a number of vulnerabilities that could result in inappropriate access to Medicare information and networks. At one contractor site, auditors observed unauthorized wireless access to the Medicare networks. To make matters worse, CMS did not require all Medicare contractors to review user access to sensitive Medicare data.

These are just a sample of a long list of troubling findings. The Ernst & Young audit, which was completed at the end of FY 2010, also included a number of recommendations that would move the Department into fuller compliance with its obligations. By Thursday, March 31, 2011, please provide the Department’s detailed corrective action plan and an update of any corrective actions that have taken place since the audit was issued.

In addition, in reference to the “Nearly $2 Billion Taxpayer Dollars in Limbo” described above, please provide details for any transactions that have remained open without activity for more than two years, including information detailing the parties to the transaction, the amount of the transaction, and a description of the subject of the transaction.

Finally, please detail the actions the Department will take to update CMS’ mainframe systems and software used to process Medicare and Medicaid data that the audit noted “will become more difficult to maintain and modify when integrating future changes in the Medicare program.”

We know you share our determination to better protect taxpayer dollars, ensure the efficient management of government, and prevent the unauthorized access of Medicare beneficiary information. We look forward to receiving your response and thank you in advance for your assistance as we fulfill our Constitutional oversight responsibilities. If your staff should have any questions, they should contact Chris Armstrong with the Ways and Means Subcommittee on Oversight at (202) 225-5522, or Josh Trent with the Senate Permanent Subcommittee on Investigations at (202) 224-5754.

Sincerely,

Charles Boustany, MD

Tom Coburn, MD

PDF version of the letter here.

Proposed discretionary program reductions and terminations for FY2012 HERE.

Summary of each program termination outlined in the President's budget HERE.

Dr. Coburn's bill to enact President Obama's program terminations, text HERE.

Table of contents from President Obama's budget section on "Terminations, Reductions, and Savings" for Fiscal Year 2012 budget HERE.

Read the original letter HERE.

Dear Colleague,

With our national debt poised to reach its $14.3 trillion limit within the very near future, taxpayers expect we will work together to reduce wasteful and unnecessary spending and be more vigilant about how we spend public funds. As stewards of our nation’s finances, we must ensure our good intentions today are not paid for at the expense of future generations. This means no longer spending money we do not have to pay for programs we do not need.

The House of Representatives has enacted a number of requirements to ensure any bill considered by the chamber does not grow the size or cost of the government or increase our national debt. We believe the Senate should apply these and other commonsense practices to restore fiscal responsibility and increase accountability and transparency to the legislative process.

We, therefore, are notifying you of our intention to object to the consideration of any legislation that fails to meet any of the following standards:

• All New Spending Must Be Offset with Cuts to Lower Priority Spending: Congress authorizes billions of dollars in new spending every year to create new or expand existing government programs. Yet, few bills are passed to eliminate outdated, duplicative, unnecessary, inefficient, wasteful, or low priority programs. To make government more efficient, any legislation authorizing new spending or creating a new agency, office, program, activity, or benefit or increasing the authorization of an existing function must offset the cost of this expansion by eliminating an existing program or function or reducing the authorized funding level of ongoing spending.

• Government Programs Must Be Periodically Reviewed and Renewed: Never ending government programs must end. Congress should periodically determine whether or not every government program is working as intended, is still needed, or is worthy of continued taxpayer support. To ensure this happens, any legislation establishing or continuing an agency, office, or program must also include a “sunset” date at which point Congress must decide whether or not to update or extend the life of the program.

• The Cost and Text of Bills Must Be Available Prior to Passage: Too many bills costing billions of dollars with far reaching implications are approved by the Senate with little debate, few if any amendments, and not even time to read the actual text of the legislation. To guarantee taxpayers and senators have sufficient time to read bills and information to understand their cost and impact, all legislation must be publicly available in an electronic format for at least three full days along with a cost estimate completed by the Congressional Budget Office (CBO) prior to being passed.

• Duplicative Government Programs Must Be Consolidated or Eliminated: Despite the existence of hundreds of duplicative federal programs costing billions of dollars, Congress continues to create new programs with similar missions, goals, and purposes. To reduce redundancy, any bill creating a new program that replicates a current government mission must consolidate overlapping activities or eliminate the existing programs.

• Congress Must Not Infringe Upon the Constitutional Rights of the People: Article I, Section 8 of the Constitution grants Congress a very limited set of enumerated powers. Far too often, Congress infringes upon the rights and liberties reserved for the people and the states provided elsewhere in the Constitution. These overreaches are no more than an afterthought when most bills are debated. To restore the intended balance of powers between the states and the federal government and to preserve the freedoms guaranteed by the Constitution, all bills must have a clear and obvious basis connected to one of the enumerated powers and must not infringe upon any of the rights guaranteed to the people.

By making clear these expectations now, it is our hope we can work together earlier in the legislative process to resolve any differences that could otherwise delay or stop the passage of your legislative priorities. And while we expect all of these standards to be met for each bill the Senate considers, this is not an exhaustive list of all the reasons we may individually object to a particular bill or unanimous consent request.

Sincerely,

Tom Coburn, M.D.

John McCain

Jim DeMint

Rand Paul

Kelly Ayotte

John Ensign

Michael Lee

Ron Johnson

Today CBO released a full score of repealing the Democrats’ health overhaul.  Here are some highlights.

• Repeal saves taxpayers $1.39 trillion from expenditures in Medicaid, Children’s Health Insurance Program (CHIP), and tax credits for certain small employers from 2012 to 2021. (p.4)

• In total, CBO and JCT estimate that repeal would reduce outlays by about $604 billion and reduce revenues by about $813 billion over the 2012-2021 period. (p.4)

• Repeal would mean about 33 million fewer nonelderly people would have health insurance in 2021, leaving a total of about 57 million nonelderly people uninsured. (p. 7)  Note that the 2010 Census found there are currently 50 million Americans without health insurance.

• CBO estimates about 2 million more Americans would have health coverage from their employer (p. 10).

• CBO estimates repeal would reduce state government’s spending for Medicaid and CHIP by about $60 billion over the 2012-2021 period. (p.11)

• CBO projects that enacting H.R. 2 would reduce the “federal budgetary commitment to health care” by $464 billion over the 2012–2021 period. (p. 18)

• Repeal means “premiums for health insurance in the individual market would be somewhat lower than under current law.” (p.19)

In 2009, the Internal Revenue Service (IRS) found nearly 100,000 civilian federal employees were delinquent on their federal income taxes, owing over $1 billion in unpaid federal income taxes. When considering retirees and military, more than 282,000 federal employees owed $3.3 billion in taxes.

This legislation will save taxpayers at least $1 billion by requiring the Internal Revenue Service (IRS) to collect unpaid federal income taxes from civilian federal employees.

The bill requires all federal employees to be current on their federal income taxes or be fired from their jobs. This is a common sense bill that most Americans would believe is reasonable, necessary, and likely surprised that it is not already the standard throughout the federal government.

Click here for the bill's text.

Click here for additional background information.

Dr. Coburn has filed five amendments to the FAA reauthorization bill (S.233) that address his primary concerns with the bill. Highlighted areas of concern include the following points:

• The Airport and Airway Trust Fund Has Been Drained,
• NextGen Development Has Been Slow,
• Wasteful Spending and Duplicative Spending Must Be Eliminated

Passing an FAA reauthorization bill is a national priority and one Congress has failed to address over the last three years. There are many good things included in the underlying bill the Senate is considering, including the creation of a new funding account for NextGen technology development, additional passenger rights protection, and numerous provisions ensuring NextGen development is prioritized and more effectively implemented by FAA.

Unfortunately, this bill also reauthorizes and increases spending for programs of questionable merit and federal policies that have helped drain the Airport and Airway Trust Fund (AATF) while increasing General Fund revenues for aviation projects and, consequently, our national debt.

While this bill increases taxes on smaller non-commercial air planes, it must also cut wasteful and duplicative spending to ensure national aviation priorities are adequately funded and our debt does not continue to increase. Unfortunately, there hasn’t been a strong emphasis by the Senate to find ways to reduce waste and duplication as well.

Amendment #91: to decrease the federal share of project costs under the airport improvement program for non-primary airports. For additional background on this amendment, click here.

Amendment #64: to rescind unused earmarks. For additional background on this amendment, click here.

Amendment #80: to limit essential air space to locations that are 100 miles or more away from the nearest medium or large hub airport. For additional background on this amendment, click here.

Amendment #81: to limit essential air service to locations that average 10 or more enplanements per day. For additional background on this amendment, click here.

Amendment #82: to repeal the small community air service development program. For additional background on this amendment, click here.

Click HERE for a list of airports that would be affected by these amendments.

In a letter sent to all four military Chiefs of Staff, Dr. Coburn expresses the serious need for the Department of Defense to be committed to improving its financial management, as well as to consider the recommendations outlined in the report offered by the National Commission on Fiscal Responsibility and Reform, and to develop auditable financial statements.

Read the letter sent to the Military's Joint Chiefs of Staff: here

On January 6th, the Congressional Budget Office (CBO) released a preliminary analysis of H.R. 2—a bill to repeal the Patient Protection and Affordable Care Act (1). Democrats are using that analysis to say that repealing the law will increase the deficit by $230 billion dollars. But a closer look shows the the federal health care law could add nearly $700 billion to the deficit in the first ten years alone.

Response

• Only in Washington would people believe that deciding NOT to spend $2.6 trillion dollars over a decade, and NOT massively expand the federal government can be spun as being somehow fiscally irresponsible.

• The problem is not the Congressional Budget Office. CBO is full of dedicated, nonpartisan budget professionals.

• The problem is that Democrats used budget gimmicks to manipulate the CBO score of the health care law. Those gimmicks make the law appear one way, but the truth is the federal health care law could add nearly $700 billion to the deficit in the first ten years alone.

Look At What CBO Really Said About Repeal

• In their cost analysis of repealing the law, CBO acknowledged they had to accept budget gimmicks and score the bill as it was written.
  • “As with all of CBO’s cost estimates, [our] estimates reflect an assumption that the provisions of current law would otherwise remain unchanged throughout the projection period and that the legislation being considered would be enacted and implemented in its current form. CBO’s responsibility to the Congress is to estimate the effects of proposals as written and not to forecast future legislation.” (2)

• CBO admitted the bill’s actual costs of the health overhaul could be much higher.
  • “Projections of the bill’s budgetary impact are quite uncertain…..CBO believes that its estimates of the net budgetary effects of health care legislation have a roughly equal chance of turning out to be too high or too low.”

• In fact, CBO acknowledged that some key provisions “might be difficult to sustain over a long period of time” at which point, the “budgetary effects of repealing [the health care law] could be quite different” – in other words, it could cost a lot more.
  • “The budgetary impact of repealing [the health care law] could be quite different if key provisions of that original legislation would have subsequently been changed or not fully implemented….. Current law now includes a number of policies that might be difficult to sustain over a long period of time….If those provisions would have subsequently been modified or implemented incompletely, then the budgetary effects of repealing PPACA and the relevant provisions of the Reconciliation Act could be quite different—but CBO cannot forecast future changes in law or assume such changes in its estimates.”

CBO Did Say Repealing the Law Would Decrease Costs for Families and Taxpayers

• Repeal Reduces Health Insurance Costs for Americans. CBO: "In particular, if H.R. 2 was enacted, premiums for health insurance in the individual market would be somewhat lower than under current law…”

• Repeal Reduces Federal Spending on Health Care. “Last March, CBO estimated that enacting PPACA and the relevant provisions of the Reconciliation Act would increase the ‘federal budgetary commitment to health care’ by about $400 billion over the 2010–2019 period; CBO uses that term to describe the sum of net federal outlays for health programs and tax preferences for health care.7 In contrast, CBO estimated that enacting that legislation would reduce the federal budgetary commitment to health care during the decade after 2019.”

Democrats Used At Least Seven Budget Gimmicks to Game the CBO Scoring Process (3):

1. Counting a full ten years of tax increases to pay for only six years of new health care spending. This means imaginary savings from CBO, but deficits in the real world.

2. Double-counting $398 billion in Medicare cuts. Democrats count it both as money to extend the life of Medicare and as money to pay for a new health care entitlement. So that is $2 spent for every $1 “saved.”

3. Concealing the cost of the so-called doc fix, which prevents cuts in Medicare payments to physicians—totaling $208 billion over ten years. This cheats the doctors or it cheats the taxpayers.

4. Spending $29 billion in Social Security payroll taxes, even though those dollars should be used for Social Security benefits. This is a fiscal shell game.

5. Ignoring $115 billion in costs to implement the bill, including new personnel. CBO doesn’t count the cost of new bureaucrats to implement the law, but you’ll still be picking up the tab.

6. Counting $19 billion in savings from unrelated student loan reforms as health care savings. One more way to mask the massive law’s true cost.

7. Counting $70 billion of premiums from a new long-term care program that the even the Democratic Chairman of the Budget Committee called a “ponzi scheme.” According to the CBO, this program could “add to budget deficits …. in succeeding decades – by amounts on the order of tens of billions of dollars for each 10-year period.”(4)

Download PDF version here

Sources:

1. Legislative Information System, H.R. 2, 112th Congress, http://www.congress.gov/cgi-lis/bdquery/D?d112,d111:1:./temp/~bdeHF1:dbs=y:|/billsumm/billsumm.php|

2. This and all quotes from CBO taken from the January 6th letter to Speaker Boehner, http://www.cbo.gov/ftpdocs/120xx/doc12040/01-06-PPACA_Repeal.pdf

3. First six gimmicks taken from Senate GOP Budget staff document, http://budget.senate.gov/republican/pressarchive/2011-01-19Obamacare&Deficit.pdf.

Summary of CLASS program, page 18 here, http://coburn.senate.gov/public//index.cfm?a=Files.Serve&File_id=0d0b33ae-292e-42ba-ba94-43ff234961a2

4. Congressional Budget Office, “Letter to The Honorable Tom Harkin, Chairman of the U.S. Senate Committee on Health, Education, Labor, and Pensions,” November 25, 2009. http://www.cbo.gov/ftpdocs/108xx/doc10823/CLASS_Additional_Information_Harkin_Letter.pdf

Today the Congressional Budget Office (CBO) released its preliminary analysis of H.R. 2—a bill to repeal health care law—that will is expected to pass the House when it receives a vote on January 12th.

While some news headlines focus on the projected deficit increase from repealing PPACA and HCERA in this particular analysis, CBO did not account for the budgetary impact of the CLASS Act, untenable Medicare cuts, or other provisions widely critiqued by nonpartisan experts as unsustainable. CBO has commented about some such provisions here. Dr. Coburn has produced an analysis of the CLASS Act on page 18 here.

Beyond the headlines, it’s important to look at what CBO actually said…..

• Repeal Reduces Health Insurance Costs for Americans. "In particular, if H.R. 2 was enacted, premiums for health insurance in the individual market would be somewhat lower than under current law…”

• Repeal Reduces Federal Spending on Health Care. “Last March, CBO estimated that enacting PPACA and the relevant provisions of the Reconciliation Act would increase the “federal budgetary commitment to health care” by about $400 billion over the 2010–2019 period; CBO uses that term to describe the sum of net federal outlays for health programs and tax preferences for health care.7 In contrast, CBO estimated that enacting that legislation would reduce the federal budgetary commitment to health care during the decade after 2019.”

• CBO Reviewed the Repeal Bill, But a Detailed Analysis is Still Forthcoming. “The Congressional Budget Office (CBO) has reviewed H.R. 2, the Repealing the Job-Killing Health Care Law Act, as introduced on January 5, 2011. That bill would repeal the Patient Protection and Affordable Care Act (PPACA, Public Law 111-148) and the provisions of the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) that are related to health care….. CBO has not yet developed a detailed estimate of the budgetary impact of repealing that legislation, although it is working with the staff of the Joint Committee on Taxation (JCT) to complete such an estimate in the near future. Because Congressional deliberations on H.R. 2 could begin very soon, CBO is providing in this letter a less-detailed preliminary analysis of that legislation.”

• The Promised Deficit Reduction From the Overhaul Has Changed Slightly. “The projected increase in deficits will not be exactly the same as the reduction in deficits that was originally estimated to result from the enacted legislation….[because] the economic outlook is now somewhat different…. Some of the funding provided by the legislation enacted last March has been obligated or spent… Subsequent legislation has already modified the laws enacted last March.”

• Now Repeal “Costs” $145 Billion. “CBO expects that enacting H.R. 2 would probably increase federal budget deficits over the 2012–2019 period by a total of roughly $145 billion..”

• But CBO Was Forced To Score the Initial Bill –Full of Smoke and Mirrors – as it Was Written. “As with all of CBO’s cost estimates, those estimates reflect an assumption that the provisions of current law would otherwise remain unchanged throughout the projection period and that the legislation being considered would be enacted and implemented in its current form. CBO’s responsibility to the Congress is to estimate the effects of proposals as written and not to forecast future legislation.”

• CBO Admits Actual Costs of the Overhaul Could Be Much Higher. “Projections of the bill’s budgetary impact are quite uncertain…..However, CBO’s staff, in consultation with outside experts, has devoted a great deal of care and effort to the analysis of health care legislation in the past few years, and the agency strives to develop estimates that are in the middle of the distribution of possible outcomes. As a result, CBO believes that its estimates of the net budgetary effects of health care legislation have a roughly equal chance of turning out to be too high or too low.”

• So, if the Current Law Were Changed Significantly (As Many Experts Anticipate), Repealing the Overhaul Could Reduce the Deficit.

“The budgetary impact of repealing PPACA and the provisions of the Reconciliation Act related to health care could be quite different if key provisions of that original legislation would have subsequently been changed or not fully implemented….. Current law now includes a number of policies that might be difficult to sustain over a long period of time. For example, PPACA and the Reconciliation Act reduced payments to many Medicare providers relative to what the government would have paid under prior law. On the basis of those cuts in payment rates and the existing “sustainable growth rate” mechanism that governs Medicare’s payments to physicians, CBO projects that Medicare spending (per beneficiary, adjusted for overall inflation) will increase significantly more slowly during the next two decades than it has increased during the past two decades. If those provisions would have subsequently been modified or implemented incompletely, then the budgetary effects of repealing PPACA and the relevant provisions of the Reconciliation Act could be quite different—but CBO cannot forecast future changes in law or assume such changes in its estimates.”

Amendment #4764 and #4765 would pay for the costs of extending unemployment insurance payments by reducing unnecessary and duplicative spending.

Click here for amendment #4764 text.

Click here for amendment #4765 text. Click here for additional background.

Overview of amendment #4765 —To offset some of the costs of the bill by cutting wasteful spending, eliminating unnecessary programs, and consolidating duplicative programs.

Every member of the Senate claims they want some portion of this bill to be paid for. This amendment would provide an opportunity to do so.

According to the Congressional Budget Office (CBO), the total increase to the deficit resulting from both the revenue and spending provisions contained within the tax/unemployment insurance (UI) extension bill will be $857.8 billion. Specifically, the bill will increase spending by $136.4 billion.

The bill is written to exempt itself from PAYGO rules which require legislation increasing spending or reducing revenues to be offsets to prevent deficit spending.

This amendment provides $46 billion in savings this year and $156 billion over five years, thereby allowing the Senate to pay for a portion of the bill’s total cost.

The national debt now exceeds $13.8 trillion and the U.S. is expected to reach its debt limit of $14.3 trillion within the next couple months. Congress will then be faced with approving more borrowing or imposing dramatic spending cuts or tax increases. To prevent or reduce the severity of these options, Congress needs to at the very least stop adding to the deficit now.

The U.S. government has run a deficit for 26 straight months. The fiscal year 2010 deficit was nearly $1.3 trillion and the 2009 deficit was $1.4 trillion, the two largest budget shortfalls in history. The deficit for this fiscal year, which just began on October 1, is already more than $290.8 billion and is likely to set a new record high. Unless Congress takes action, $1 trillion annual deficits are projected every year for the foreseeable future, which is clearly an unsustainable amount of borrowing.

Senators cannot say they are concerned about the cost of new spending or the loss of revenues resulting from not increasing taxes while at the same time refusing to provide any suggestions for offsets or rejecting those others are offering.

This amendment provides tens of billions of dollars of savings by eliminating wasteful spending, consolidating duplicative programs, and requiring greater efficiency by all federal agencies. It includes ideas proposed by both Republicans and Democrats. It includes suggestions from President Obama’s bipartisan deficit reduction as well as ideas to terminate programs proposed by both Presidents George W. Bush and Barack Obama.

Among the savings proposed by this amendment:

• A congressional pay freeze and a 15 percent reduction in Congress’ budget;

• A freeze on how much can be spent on the salaries for federal employees and a reduction in the number of government bureaucrats;

• Limiting the amount that the government can spend on printing, travel, and new vehicles;

• Selling unneeded and excess federal property;

• Stopping unemployment benefit payments to jobless millionaires;

• Collecting unpaid taxes owed by federal employees and members of Congress;

• Consolidating duplicative government programs;

• Preventing fraud within federal health care programs;

• Streamlining Defense spending and reducing foreign aid, including voluntary contributions to the United Nations.

This bill is not paid for and the Majority Leader is blocking amendments to pay for the bill’s costs. A vote to suspend the rules to allow consideration of this amendment would allow the Senate to debate the merits of paying for the spending in the underlying bill rather than simply adding billions of dollars to the national debt.

Dr. Coburn has filed the following substitute amendment to S.510, FDA Food Safety Modernization Act:

The Ensuring Greater Food Safety Act of 2010 would modernize Federal food safety efforts without placing unnecessary burdens on food producers, increasing food prices, or saddling taxpayers with additional debt.

Click here for the text of Dr. Coburn's amendment; the Ensuring Greater Food Safety Act of 2010.

Click here for a section-by-section outline of the Ensuring Greater Food Safety Act.

Click here for a two page summary of the Ensuring Greater Food Safety Act.

An amendment to establish an earmark moratorium for fiscal years 2011, 2012, and 2013.

Click here for the text of the amendment.

Click here for additional background.

U.S. Senators and physicians Tom Coburn and John Barrasso released a new oversight report on the federal health law, detailing how many of the economic and financial consequences of the new law are worse than anticipated.

Click HERE to see what others are saying about Grim Diagnosis…

Outgoing Democratic Governor of Tennessee, Phil Bredesen, provides many paralleled critiques of the new health care law in his new book, Fresh Medicine.

Summary of Governor Bredesen’s “Fresh Medicine” below:

DEMOCRATIC GOVERNOR SAYS HEALTH CARE LAW MADE PROBLEMS “WORSE”

Governor Phil Bredesen (D-TN) Offers Scathing Critique of Health Care Law

“Congress and the Obama Administration have just added over thirty million people

into an obsolete and broken system and done little to address the underlying problems;

in multiple ways, they’ve made them worse.” (introduction)

Deficits Will Soar Higher

• “We talk about ‘not increasing the deficit,’ which is Washington speak. The structural deficit is expanding and will continue to expand at a dangerous rate.” (p. 27)

• “The passage of the Affordable Care Act was made politically acceptable by setting up a straw man: would it reduce the deficit or not? When CBO announced that the legislation would indeed reduce it, the political path to passage was cleared. But if we make even the most obvious and sensible real-world adjustments to their analysis, the answer is different. Take out the CLASS Act funds—no insurance company in America would be allowed to do what the CBO rules permitted. Add an estimate of the real cost of appropriations that were made for one year but clearly intended to be continued, and include an estimate of the new administrative costs in HHS and the IRS. In May, well after Affordable Care Act’s passage, the CBO added an additional $115 billion to the cost of the legislation to reflect these. Add an estimate for the appropriations for which there were no numbers, only ‘sum sufficient’ language. These are not esoteric adjustments, just commonsense ones. But when they’re made, the legislation no longer ‘reduces the deficit,’ it adds to it. If you don’t believe the Medicare rate reductions will actually happen, it adds even more.” (p. 38)

Costs Will Continue Increasing

• “This year’s reform presented a fine opportunity to make some progress in containing the costs of our health care and we passed it up… Its attention to controlling costs is limited, in the future, and has an air of wishful thinking about it.” (p. 26)

• “We failed to use the opportunity to address the cost issue substantively. Worse yet, we also did some things likely to make our health care obligations even more expensive in the years ahead.” (p. 30)

• “Let me make a prediction here: subsidized, Individual Exchange-based health insurance is an open-ended entitlement that will ultimately, and perhaps quite quickly, create extremely large and unbudgeted costs for our federal government.” (p. 32-33)

• “Even associates of mine who strongly support the Affordable Care Act acknowledge privately that its main purpose has been expanding coverage. Their argument is that we need to do the expansions now and we’ll revisit costs once the new coverage is in place. But this is a terrible strategy.” (p. 35)

• “[W]hen you’re in a boat that is taking on water fast and may sink, you don’t try to ‘bend the curve’ of how much water is coming in; you try to plug the hole and start bailing. The cost control provisions of the Affordable Care Act don’t plug the hole we already have, punch a few new ones for good measure, and bail with a paper cup.” (p. 35)

Reform Makes Current Health Care Problems Worse

• “What a stunning disappointment. The health care “reform” we finally wrote into law isn’t transformational. It provides health insurance for a great many more people, but doesn’t directly attack any of the deep structural problems of health care.” (p.12)

• “Even seen through [a] practical filter, what we finally accomplished is still a deep disappointment.” (p.12)

• “It’s as if we had inherited a proud old house that had deteriorated over the years. Now it’s in disrepair- sagging floors, rusty pipes, and costing a fortune to maintain. Bur rather than rolling up our sleeves….we choose to tack a cobbled-together addition on the back, slap a coat of paint on everything, and pronounce it fixed.” (p. 12)

• “[T]he president left the design of his reform to the most partisan body in America. Democrats were firmly in the majority and wrote the legislation, and the dream of beginning a new post-partisan era came down to the chairman of the Senate Finance Committee trying to find a few tweaks that might dress up the final vote with a Republican senator or two.” (p. 39-40)

Employers Will Drop Coverage

• “[The discrepancy between a fine of a few thousand dollars and the much higher cost of contributions to employees’ health policies] isn’t going to be a small effect. Employers with tens of millions of employees in their organizations are going to take a hard look at this. It represents a genuine design flaw in the Exchange system—setting up the economic incentives to favor exactly what you don’t want: employers dumping into the federal system. Perhaps it’s an oversight by the designers who aren’t really attached to the world where nickels and dimes count. Or it may be just what they’re counting on, as a back-door approach to a government-run system.” (p. 32)

• “[S]ubsidized Exchange health insurance is structured to be so much more attractive than other alternatives that I believe it’s likely to grow, and with it the federal entitlement subsidies, far beyond the scope that was originally anticipated. What will make it grow is a third group that can potentially enter—those who now have group insurance. There are a lot of businesses—small, medium, and large—in America that, when they do the numbers, are going to discover that dropping the health insurance coverage they now offer and moving their employees into the Individual Exchange program is better for them….” (pp. 30-31)

• “For a great many employers, when they compare the total costs of dropping coverage with those of keeping it, dropping it will make good financial sense. Even today, there’s already significant erosion of group health insurance as firms face economic pressure. Once there’s a clear path that doesn’t hurt their employees; dropping coverage will be a very attractive option.” (p. 31)

• “I’m confident that many employers are looking hard at these options now, and by 2014 there will be a mini-industry of consultants to show them how to do it and what they can save.” (p. 31)

• “If someone were starting a company in 2014, it would be a perfectly sensible business decision for them to decide right at the start to permanently stay out of the business of offering health insurance.” (p. 32)

• “As these small businesses grow, some will reach a size where fines would start to apply, but a fine of two or three thousand dollars will look very attractive as an alternative to a contribution of $15,000 or more for an employer-sponsored family policy.” (p. 32)

Taxpayers Could Face Bailout of CLASS Program

• “[T]he CLASS Act (that’s the Community Living Assistance Services and Supports program)… creates an entirely new entitlement apart from the coverage expansion for the uninsured… But its terms quite obviously open it to strong adverse selection—signing up a disproportionate number of sick people. The ink was hardly dry on the Affordable Care Act before the CMS actuary stated that the CLASS Act would be out of money by about 2025. At that point, we will have been taking our citizens’ good faith premium for ten years. We’re not going to fail to honor our obligations and we can expect to be subsidizing this entitlement in growing amounts in the years ahead.” (p. 34)

• “But [CBO] work[s] within the framework of a set of rules that sometimes conceal the underlying realities. In their ‘scoring’ of the Affordable Care Act, for example, one of the significant ways of paying for expanding health insurance coverage was the use of premiums from the new CLASS Act entitlement that was established. The legislation begins collecting premiums for this insurance in 2015, but doesn’t begin paying out benefits until 2020 (conveniently, here in 2010, just outside of the CBO ten-year time horizon). The CBO ‘scoring’ of the legislation takes those first five years of premiums and diverts them to paying for its expansion of coverage. This diversion represents $70 billion of the offsets to the cost of the legislation. It assumes that when it becomes necessary to begin paying benefits in 2020, there will be other premiums from other Americans to cover the cost. When an insurance company in Tennessee …occasionally does this—collects insurance premiums and diverts them elsewhere, planning to pay claims later with other premiums—we shut them down.” (p. 37)

State Costs Increase, In “Worse” Financial Shape

• “States are being put in a box. Most are prohibited from borrowing money to balance budgets and Medicaid increasingly shoulders aside investments in other areas such as education and infrastructure. In Tennessee, Medicaid didn’t exist in 1965, and in 1981 its budget was about half of what we spent on K-12 education, it surpassed spending on K-12 in 1992, and by 2004 it was 2.25 times our K-12 budget. With the Affordable Care Act, it will get worse.” (p. 26)

Consolidation Will Increase Costs

• “As the dominance of a few large insurers in a market diminishes, more economic power accrues to providers, and especially large providers. Their ability to dictate rates and terms grows. Forcing competition and fragmentation among those paying for care while simultaneously encouraging cooperation and consolidation among providers will cause medical costs to go up, not down. Moreover, new constraints placed on the insurance industry in the name of reform hinder the insurers’ ability and incentive to innovate.” (p. 33)

• “The Affordable Care Act pushes the consolidation of hospitals and provider groups while disarming the purchasers. As this market power disparity between purchasers and providers grows, we can expect medical costs in many markets to go up at rates in excess of even the already high rate of health care inflation. This won’t be due to health care’s usual suspects of technology or overutilization, but just because of good old-fashioned monopoly market power.” (p. 34)

Government Will Grow

• “Government loves complexity, rules, and red tape, but we may have outdone ourselves this time. Reform offered a chance to clean up the baroque system we have created over the years, reduce bureaucracy, lower administrative cost, and give clarity and focus to a major part of where we spend our taxpayer’s money. Instead, we created yet more complexity, more regulations, and the need for more bureaucracy.” (p. 35)

(Washington, DC) -- A new analysis by the nonpartisan Congressional Research Service (CRS)[1] found that the Secretary of the U.S. Department of Health and Human Services (HHS) failed to meet one-third of the deadlines mandated by the new federal health care law, the Patient Protection and Affordable Care Act. The memo, requested by Republican Senators Coburn, Hatch, and Cornyn, revealed that HHS failed to fulfill its requirements in seven of 22 deadlines before September 23, 2010, which was the six-month mark of the law being enacted.

In addition to the seven missed deadlines, the CRS memo also noted four deadlines which for which there was insufficient public information available to draw a conclusion. Republican health staff pointed out that HHS may have failed to meet these four deadlines as well.

During the height of the health care debate in Congress last year, Senators Coburn, Hatch, and Cornyn warned the American people about the pitfalls of health care legislation that would empower the Secretary of HHS with unprecedented new authorities. Senate staffers totaled more than 1,700 places in the law where the Secretary is given new abilities to write rules, establish programs, and mandate requirements. Now, nonpartisan analysis shows that HHS has failed to even meet 22 mandatory deadlines required by law during the first six months of the law being enacted.

Future months are unlikely to see HHS improve its record of compliance. The Department failed to meet one-third of 22 deadlines in six months, yet now the Department has less than three months to meet another 29 requirements required by law.

The CRS analysis did not include deadlines imposed upon individuals or organizations other than the Secretary of HHS, nor did it include any provisions that did not require the Secretary to take a specific action by a specific date. CRS’ analysis was “based on information from official publicly available sources such as the Federal Register and agency websites.” The analysis was finalized on the six-month mark – September 23, 2010– so only actions taken the Secretary of HHS by that date were analyzed.

Click here for a table of missed deadlines.

Click here for the CRS analysis on HHS failure to meet deadlines.

As the Senate rushes to adjourn, Senator Tom Coburn will seek this afternoon to pass a number of bills that have been blocked by the Majority that would address many of the real concerns of the nation. These include a balanced budget requirement, an extension of tax cuts and requirements for federal employees—including members of Congress—to pay their taxes. Senator Coburn will ask the Senate to pass these bills by unanimous consent (UC) this afternoon around 4:45 p.m. If no Senator objects at that time, the bills will be approved by the Senate.

Click here for more information about the competing priorities of the Senate.

Click here to read Senator Coburn's letter to Senator McConnell, reserving the right to object to proceeding to unanimous consent on the bills offered by Majority Leader Reid.   

Althought these bills are well-intentioned, they are clearly not immediate priorities and spend money that we do not have. On the Senate floor this morning Dr. Coburn responded to Majority Leader Reid’s proposed legislation including a bill to protect shark fins, marine mammals rescue assistance legislation, and the Great Cats and Rare Canids Act, by stating his position. “The problems that are facing this country are so big and so massive that our attention ought to be focused on those large problems, not on five separate bills that have been proffered for special interest groups.”

Below is a list of some of the bills Senator Coburn may seek to pass by UC:

1) Balanced Budget Amendment to the Constitution of the United States (S. J. Res. 38): A joint resolution proposing a balanced budget amendment to the Constitution of the United States.

2) Tax Hike Prevention Act of 2010 (S. 3773): A bill to permanently extend the 2001 and 2003 tax relief provisions and to provide permanent AMT relief and estate tax relief, and for other purposes.

3) Tax cheats bill for members of Congress: A bill to require Members of Congress to disclose delinquent tax liability, require an ethics inquiry, and garnish the wages of a Member with Federal tax liability.

4) Tax cheats bill for federal employees (S. 3790): A bill to amend title 5, United States Code, to provide that persons having seriously delinquent tax debts shall be ineligible for Federal employment

5) The Earmark Transparency Act (S. 3335): a bill that meets President Obama’s call for Congress to create a single, searchable database of all congressional earmark requests. Click here for additional background on S.3335.

6) Stop Secret Spending (S.RES.622): bill would prohibit legislation from passing through the “hotline” process until members have been given 72 hours to review the bill and its costs. Billions of dollars of secret spending are authorized every year using the “hotline” process. If a Senator is going to faithfully execute his or her duties, enough time must be available to review the legislation as well as a score of the bill’s costs.

7) Excluding Abortion Coverage from Health Reform Act (S. 3723): Amends the Patient Protection and Affordable Care Act to prohibit federal funds from being to be used to cover any part of the costs of any health plan that includes coverage of abortion services.

8) The Firearms Fairness and Affordability Act (S. 632): Amends the Internal Revenue Code to require excise taxes on recreational equipment to be due and payable on the date for filing the return for such taxes.

9) Veterans 2nd Amendment Protection Act (S. 669): Prohibits, in any case arising out of the administration of laws and benefits by the Secretary of Veterans Affairs (VA), considering any person who is mentally incapacitated, deemed mentally incompetent, or experiencing an extended loss of consciousness from being considered adjudicated as a mental defective for purposes of the right to receive or transport firearms without the order or finding of a judge, magistrate, or other judicial authority of competent jurisdiction that such person is a danger to himself or herself or others.

Today, Dr. Coburn introduced the Long-Term Care Bailout Prevention Act (S. 3829) with Sens. Graham, Chambliss, McCain and Cornyn. This bill would strike the CLASS Act (long-term care) provision from the recently passed federal health care overhaul (Patient Protection and Affordable Care Act, Public Law Number 111-148). Dr. Coburn’s support for repealing the damaging CLASS provision is part of his fundamental support for repealing the health care overhaul in its entirety. (Although the bill as it stands now does not include funding that is offset, Dr. Coburn is committed to working with the sponsors of S.3829 to ensure the bill is paid for in its entirety.)

While Dr. Coburn supports improvements to long-term care, the CLASS Act provisions must be repealed in their entirety. While the CLASS program is projected to create an initial surplus that is used to pay for the programs created by the Patient Protection and Affordable Care Act, the Chief Actuary of the Centers for Medicare & Medicaid Services (CMS) has stated that by 2025, benefit payments will exceed premium revenues and the CLASS program will run deficits. The CMS Chief Actuary has said, ‘‘In general, voluntary, unsubsidized, and non-underwritten insurance programs such as CLASS face a significant risk of failure as a result of adverse selection by participants.’’ According to an August 2010 survey by the National Business Group on Health, only 3 percent 10 of employers would participate in the CLASS program. Because of the downward spiral created by adverse selection, the program could go bankrupt and the Secretary of Health and Human Services could be forced to drastically increase premiums to unaffordable levels or taxpayers could be asked to bailout the CLASS program. A Democratic Senator even referred to the CLASS’s financing structure as a “Ponzi scheme.”

Click here for the bill text of the Long-Term Care Bailout Prevention Act (S.3829).

Click here for PDF version

JULY 2009 – KENNEDY-DODD HELP COMMITTEE BILL

The Affordable Health Choices Act was voted out of Committee on July 15^th and introduced in the Senate on September 17^th, 2009 as S. 1679.

Below are quoted excerpts of the bill text and the Congressional Research Service’s analysis of the individual mandate and reporting of health insurance coverage. While there was clear consideration given to reporting of compliance with the mandate, there was no explicit mention in the bill of civil or criminal penalties associated with non-compliance. The excerpts have been abbreviated to consolidate the most relevant content. 

• “[The bill] includes a mandate for most individuals to have health insurance, with penalties for noncompliance.
• Most individuals who do not maintain qualifying coverage for themselves and their dependents could be required to pay an annual amount established by the Secretary of Labor of no more than $750 per person (with a limit of no more than four times the penalty in total for the taxpayer and any dependents), adjusted for inflation beginning with taxable years after 2011.
• Individuals would be required to maintain qualifying coverage, defined as coverage under a group health plan or health insurance coverage that an individual is enrolled in on the date of enactment or coverage that meets or exceeds the criteria for minimum qualifying coverage, Parts A and B of Medicare, Medicare Advantage, Medicaid, CHIP, Tricare, certain veteran's health care program coverage, Federal Employees Health Benefits Program (FEHBP), state health benefits high-risk pools….
• The individual mandate requirements would be effective beginning in tax years after December 31, 2011.
• Every person who provides health insurance that is qualifying coverage would be required to make a return, in such form as prescribed by the Secretary that
  • (1) contained the name, address, and taxpayer identification number of each individual who is covered under the health insurance that is qualifying coverage provided by such person
  • (2) the number of months during the calendar year during which each such individual was covered under the qualifying health insurance plan
  • (3) other information as prescribed by the Secretary.  
• Every person required to make a return described above, would also be required to provide, in writing, to each individual whose name was required on that return, the following information 
  • (1)  the name, address and phone number of the person required to make such return
  • (2) the number of months during the calendar year that such individual was covered under qualifying health insurance provided by such person. 
• No later than June 30 of each year, the Secretary of the Treasury, acting through the Internal Revenue Service, in consultation with the Secretary of HHS, would send a notification to each individual who files an individual income tax return and who was not enrolled in qualifying coverage with inf