MedPAC, the obscure commission that advises Congress on the inner workings of the vast Medicare system, could be headed for the health-reform spotlight. Talking yesterday with Senate Democrats about how to pay for his envisioned health overhaul, President Obama argued specifically in favor of expanding the powers of MedPAC, formally known as the Medicare Payment Advisory Commission, says Washington Post blogger Ezra Klein . Today the White House said Obama is open to giving special consideration to proposals made by MedPAC, according to Dow Jones Newswires . “Under this approach, MedPAC’s recommendations on cost reductions would be adopted unless opposed by a joint resolution of the Congress,” Obama said in a letter . As it stands now, MedPAC can only give Congress advice on Medicare matters, but can’t implement its recommendations. Sen. Jay Rockefeller last month introduced legislation to turn MedPAC into an independent executive agency, one that would be for the health-care system what the Federal Reserve Board is to the banking system. “Congress has proven itself to be inefficient and inconsistent in making decisions about provider reimbursement under Medicare,”

Rockefeller, a West Virginia Democrat, told the Charleston Gazette in introducing the bill. “Congress should leave the reimbursement rules to independent health care experts.” Rockefeller’s proposal sounds a lot like what Obama’s one-time health guru Tom Daschle was saying over a year ago about creating a health Fed. Daschle’s proposal drew fire from opponents afraid of a British-style agency that would take a hard and fast bottom line on costs, thus restricting access to medical products. In the same way, Rockefeller’s bill is likely to be controversial if conservatives and lobbyists see it as a way to ration care. Unlike Daschle’s health Fed, the MedPAC proposal deals exclusively with Medicare, though as Klein points out, Medicare rates often lead the way for private insurance rates so the impact of what happens to MedPAC would stretch well beyond Medicare itself. MedPAC in its current form has traded fire recently with private insurers over the Medicare Advantage plan. Photo of the Capitol dome by alykat via Flickr

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MedPAC Is Primed for Bigger Role in Health-Care Overhaul