GOP Raises Conflict-of-Interest Questions About Medicaid Commission

Republicans on the House of Representatives Energy and Commerce Committee are raising questions about the selection process for members of the Medicaid and CHIP Payment and Access Commission (MACPAC) commission, which recommends Medicaid policy to Congress, and expressed concerns that “there may be conflicts of interest on the panel of experts that is supposed to be independent.”

Committee Chairman Fred Upton (R-MI) and Health Subcommittee Chairman Joe Pitts (R-PA) wrote letters to the Comptroller General of the US Government Accountability Office (GAO) and the leaders of MACPAC saying that MACPAC does not have a “sufficient” conflict of interest policy and that they had concerns about the way the head of the GAO selects new commissioners.

“Without a balance of commissioners and a robust conflict of interest policy, we believe MACPAC’s recommendations will lack a needed level of independence and integrity,” the letter to MACPAC stated.

The letter to the GAO head said the Congressmen wanted to better understand GAO’s process and methodology for evaluating candidates and making appointments to MACPAC, and included a request for what steps GAO has taken to comply with the requirement for public disclosure by members of MACPAC of financial and other potential conflicts of interest relating to such members.

The letter to GAO’s head also asked if GAO examines or evaluates “the degree to which candidates have participated in advocacy or political activity that could result in a perceived or real conflict of interest and thus compromise the independence and integrity of MACPAC recommendations.” The committee members said they are not aware of any required disclosure or recusal process at MACPAC related to a commissioner’s political activity or advocacy.

The Congressmen’s letter said they found it to be a significant conflict of interest that newly appointed chair of MACPAC, Sara Rosenbaum, has joined an amicus brief in support of the administration against the US House of Representatives in a lawsuit filed against the White House. The lawsuit claims that the administration violated the law by creating subsidies under the Affordable Care Act (ACA) that were not specifically appropriated by Congress.

The Republican committee members are concerned that they are not getting the kinds of robust, independent analyses from MACPAC on issues concerning Medicaid that helps them properly oversee the program and make changes when needed.