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Obamacare’s Independent Payment Advisory Board (IPAB)

CATO reports on Obamacare’s little discussed Independent Payment Advisory Board (IPAB), a provision that makes the legislation even more authoritarian than we feared.

From the article:

IPAB consists of up to 15 unelected government “experts.” Its stated purpose is to restrain Medicare spending. If projected spending exceeds certain targets, Obamacare requires IPAB to issue “legislative proposals” to reduce future spending. Those proposals could include drastic cuts that jeopardize seniors’ access to care, leading some critics to label IPAB a “death panel.”

But the really dangerous part is that these are not mere “proposals.” Obamacare requires the secretary of Health and Human Services to implement them — which means they become law automatically — unless Congress takes certain steps to head them off. Congress may replace the Board’s proposal with its own cuts, at least initially. But Obamacare requires a three-fifths vote in the Senate to pass any replacement that spends more than the Board’s proposal. In other words, to override IPAB’s proposal completely, opponents must assemble a simple majority in the House and a three-fifths majority in the Senate and the president’s signature.

That makes IPAB more than an advisory board. It’s a super-legislature whose members are more powerful than members of Congress. If eight members of Congress propose a bill, all that’s necessary to block it is a majority of either chamber, or one-third of either chamber plus the president.



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