Health reform's bureaucratic spawn

From Gloria Park and Fred Barbash of Politico on Aug. 3:

Don’t bother trying to count up the number of agencies, boards and commissions created under the new health care law. Estimating the number is “impossible,” a recent Congressional Research Service report says, and a true count “unknowable.”

The reasons for the uncertainty are many, according to CRS’s Curtis W. Copeland, the author of the report “New Entities Created Pursuant to the Patient Protection and Affordable Care Act.”

The provisions of the law that create the new entities vary dramatically in specificity.

The law says a lot about some of them and a little about many, and merely mentions a few. Some have been authorized without any instructions on who is to appoint whom, when that might happen and who will pay.

Those agencies created without specific appointment or appropriations procedures will have to wait indefinitely for staff and funding before they can function, according to Copeland’s report.

And others could be just the opposite: One entity might not be enough and could spawn others, resulting in an “indeterminate number of new organizations.”

The CRS report cites as an example a minority health provision that “requires the heads of six separate agencies within Health and Human Services to each establish their own offices of minority health.”

Another section, by contrast, says that the Patient-Centered Research Institute “‘may appoint permanent or ad hoc expert advisory panels as determined appropriate.’ How many such panels will be ‘determined appropriate’ by the institute is currently unclear.”

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