Under Obamacare, The Independent Payment Advisory Board, more commonly known as the law’s ‘death panels’, will be made up of 15 unelected bureaucrats (appointed by Obama and the Senate) who will be bestowed with unfettered power to cut Medicare if expenditures exceed a specified target.
Moreover, the board can make further cuts even if expenditures remain below the targeted budget. One outcome of this scenario could be that, if Medicare drastically reduces reimbursement levels for specific services, physicians would indeed opt out of offering such services. This, in turn, could create medical access issues for the Medicare population.
This extra-legal, politically-insulated body encompasses both executive and legislative powers and is not subject to any meaningful checks. The Cato Institute has dubbed IPAB the most unconstitutional provision of Obamacare:
If the president fails to appoint any board members (or the Senate fails to confirm the president’s appointments, or a majority of the board cannot agree on a proposal) the Act authorizes the Secretary of Health and Human Services to exercise the board’s powers unilaterally.
Furthermore, judicial review does not exist regarding any of the board’s legislative proposals. The only way a proposal can be overturned is if Congress drafts an alternative proposal that rations Medicare just as much if not more than IPAB’s original plan of action. Finally, if an alternative obtains approval, the document makes its way to be signed off by the man who is willing to work solo with a pen and a phone.
And the only way for Congress to forever abrogate IPAB is for them to act within a specified 9-month time frame in 2017. Otherwise, Congress somehow has the right to bind future Congresses?