Mona Charen
Former House Speaker Nancy Pelosi's plea that Congress would have to pass the 906-page Patient Protection and Affordable Care Act in order to "find out what's in it" has become an instant classic in the annals of dysfunctional government. But in the months since the bill's passage, as the Department of Health and Human Services has parceled out waivers, something else has become clear: We may never know what's in it.

It's not because the legislation is so long or so complicated -- though it is staggeringly prolix and stupefying in complexity. If it were only that, time would reveal the intricacies and experts would parse the meaning.

No, the reason we may never really know what's in it is because it lodges such tremendous discretion and power in the Department of Health and Human Services that we can never really be sure how government decision-makers will interpret it. In at least 700 separate instances, the legislation says that the Secretary of Health and Human Services "shall have discretion" to make rules implementing the law's often vague requirements.

On May 13, the Obama administration announced the approval of 204 new waivers from compliance with the PPAA (Obamacare). That brings to 1,372 the number of waivers HHS has granted in the 14 months since the law's passage. The waivers are temporary, designed to prevent wholesale bankruptcies of insurance and other companies before most of the law's provisions take full effect in 2014.

"We are committed to making the waiver process transparent to the public," an HHS spokesman offered reassuringly.

But while the identities of those who have received waivers have been disclosed, the administration has so far declined to reveal the names of those whose waiver requests were denied. Nor has HHS explained its criteria.

There are rumblings of suspicion that HHS has shown favoritism -- labor unions have received some 26 percent of waivers while comprising only 12 percent of workers. As Rep. Fred Upton, R-Mich., chairman of the Energy and Commerce Committee remarked, "What does it say about the feasibility of the health care law when the administration needs to exempt over 1,000 health plans from its own law?"


Mona Charen

Mona Charen is a syndicated columnist, political analyst and author of Do-Gooders: How Liberals Hurt Those They Claim to Help .
 
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