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Congress Holds Hearing on Repealing Unique Health Identifier and Limiting Use of Social Security Numbers

June 14, 2000

The House Subcommittee on Government Management, Information and Technology held a hearing on May 18, 2000 to examine the Freedom and Privacy Restoration Act (H.R. 220). The legislation would forbid the federal government from assigning identifiers to citizens and it would help protect Americans against government surveillance, said Rep. Ron Paul (R-TX), sponsor of the legislation. Specifically, H.R. 220 would repeal the section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that requires the U.S. Department of Health and Human Services (HHS) to assign a unique health identifier to each American. It would also prohibit the use of Social Security numbers (SSNs) for purposes not related to Social Security.

Rep. Paul pointed out that federal funding for establishing a unique health identifier has been put on hold for the past two years. However, it could take effect this coming fall unless Congress acts to stop it.1

Increasing Use of Social Security Numbers

Rep. Paul told the subcommittee that since the creation of Social Security in 1935, there have been almost 40 congressionally authorized uses of the number as identification for non-Social Security programs. "Such congressional actions do not reflect the intent of the Congress that created the Social Security system as that Congress in no way intended to create a national identifier," he said. "In fact, Congress never directly authorized the creation of the Social Security number, they simply authorized the creation of an `appropriate record keeping and identification scheme.' The Social Security number was actually the creation of the Internal Revenue Service!"

Remember the IRS and FBI Abuses?

"I am sure I need not remind the members of this Committee of the sad history of government officials of both parties using personal information contained in IRS or FBI files against their political enemies," continued Paul. "Imagine the potential for abuse if an unscrupulous government official is able to access one's complete medical, credit, and employment history by simply typing the citizen's `uniform identifier' into a database. The history of abuse of personal information by government officials demonstrates that the only effective means of guaranteeing Americans' privacy is to limit the ability of the government to collect and store information regarding a citizen's personal matters. The only way to prevent the government from knowing this information is to prevent them from using standard identifiers," said Paul.

Encroaching Use of Social Security Numbers

Charlotte Twight, a professor of economics at Boise State University, also testified in support of H.R. 220. She explained that the SSN has become a key to our personal information. "Even the Secretary of Health and Human Services (HHS) now describes American Social Security numbers as a `de facto personal identifier,'" Twight said. She also noted that every child must acquire a Social Security number at birth or shortly thereafter. "How was this radical change accomplished?" Twight asked. "Much as one conditions dogs: a bit at a time-and always with a reward attached," she explained. "First, Congress required by statute in 1986 that every child claimed as a dependent on federal tax forms have an SSN by age five. Then in 1988 Congress reduced it by statute to age 2; in 1990 Congress reduced it to age one. "Finally, in 1996, Congress passed a requirement that an SSN must be presented for anyone of any age claimed on federal tax forms as a `dependent.' No SSN, no federal tax exemption. In general, to obtain any federal benefit today, tax-related or otherwise, one must present the SSNs of all parties affected."

Professor Twight concluded, "The quest for information about private citizens is a by-product of the vast substantive powers now wielded by the federal government. Dr. Richard Sobel of Harvard Law School has stated that `centralized information is centralized power.' I would add that the converse is also true: with today's technology, centralized power is centralized information." She said that H.R. 220 would be a first step toward reducing both centralized information and centralized power.

Another witness, Robert Smith, publisher of The Privacy Journal, argued that being known as a number, not a name, is dehumanizing. "It allows people in authority as well as our neighbors and co- workers to treat us as less than human," he said. Smith also stressed that Congress should repeal the law requiring a Social Security number for children 16 years or younger unless they earn reportable income.

Efficiency Versus Privacy

Government witnesses expressed concern that H.R. 220 would interfere with the efficiency of government programs. Fritz Streckewald, the Social Security Administration's (SSA) associate commissioner for program benefits, testified that the legislation would make it difficult for the SSA to exchange data with other federal, state, and local government agencies.

Streckewald pointed out that such exchanges are necessary for ensuring accurate payments. "In the use of SSNs, we must carefully weigh the balance between protection of individual privacy rights and the integrity of the Social Security programs and other benefit paying programs," Streckewald said.

General Accounting Office (GAO) representative Barbara Bovbjerg testified that health care organizations always ask patients for their SSNs, but do not deny services if refused. She based that information on GAO's contact with officials representing hospitals, a health maintenance organization, and a health insurance trade association. Bovbjerg also reported that officials in the health care industry expect use of SSNs to increase due to growing coordination among networks of health providers.

Bovbjerg also acknowledged that the widespread use of SSNs provides a means for building and sharing databases of personal information-and can lead to identity theft. She stressed that Congress must weigh concerns about both individual privacy on the one hand and accuracy, fraud and abuse on the other.

How Much is Your Privacy Worth?

One of the most disturbing arguments presented at the hearing was the cost-benefit argument. Some government officials and members of Congress are apparently willing to strip Americans of their right to privacy in order to make government programs efficient. During the question-and-answer session, a member of Congress asked Rep. Paul how much his bill would cost taxpayers. Paul responded that an official cost estimate hadn't been completed yet, but the cost of individual liberty must be factored into the equation. This leads one to ask, "How much is privacy worth?" Until that question is asked of the 277 million individuals holding Social Security numbers, the government can't say for sure whether unrestricted use of Social Security numbers is truly cost-effective.

1 Update as of June 14, 2000: The House of Representatives passed an amendment on June 13, 2000 to delay federal funding for a unique health identifier. If the amendment is signed into law, it would delay federal funding for one year only; it does not repeal the unique health identifier.

This article was originally published in the May/June 2000 issue of Health Freedom Watch.

Imagine the potential for abuse if an unscrupulous government official is able to access one's complete medical, credit, and employment history by simply typing the citizen's 'uniform identifier' into a database.