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Obamacare: Watching the IPAB Hearings

Health care costs currently consume 17% of our GDP, and 10.7% of the American workforce is employed in the healthcare industry. Keep those facts in mind as you read this.

The hearings for IPAB are taking place this week, and we need to be watching the outcome of this. Here’s the basic information needed to understand what the Independent Advisory Payment Board (IPAB) is all about….

What’s IPAB? A Beltway acronym for subverting the deliberative process.

The 15-member panel of government-appointed bureaucrats was slipped into Section 3403 of the Obamacare law against the objection of more than 100 House members on both sides of the aisle. IPAB’s experts would wield unprecedented authority over Medicare spending — and in time, over an expanding jurisdiction of private health care payment rates — behind closed doors.

Freed from the normal administrative rules process — public notice, public comment, public review — that governs every other federal commission in existence.

Without the possibility of judicial review.

And liberated from congressional oversight except through an onerous accountability procedure.

The Goldwater Institute in Arizona has filed a lawsuit challenging the constitutionality of IPAB.

“No possible reading of the Constitution supports the idea of an unelected, standalone federal board that’s untouchable by both Congress and the courts,” says the think tank’s litigation director, Clint Bolick.

The PPACA repeatedly refers to any IPAB proposal as a “legislative proposal” and speaks of “the legislation introduced” by the IPAB. Each proposal automatically becomes law unless Congress passes — with a three-fifths supermajority required in the Senate — a measure cutting medical spending as much as the IPAB proposal would.


This is a travesty of constitutional lawmaking: An executive branch agency makes laws unless Congress enacts legislation to achieve the executive agency’s aim.


And it gets worse. Any resolution to abolish the IPAB must pass both houses of Congress. And no such resolution can be introduced before 2017 or after Feb. 1, 2017, and must be enacted by Aug. 15 of that year. And if passed, it cannot take effect until 2020. Defenders of all this audaciously call it a “fast track” process for considering termination of IPAB. It is, however, transparently designed to permanently entrench IPAB — never mind the principle that one Congress cannot by statute bind another Congress from altering that statute.

There are a growing number of Democrats who are also in support of repealing the IPAB provisions included in Obamacare, so we might actually see a true bipartisan effort to get this provision stricken from the law.

During the Congressional House hearings yesterday, DHHS Secretary Sebelius portrayed IPAB as being “a harmless “backstop mechanism” with limited powers to do anything at all to control costs” and “just another run-of-the-mill dog-and-pony panel that would be “irrelevant” if Congress so chooses”

Not for a single second am I inclined to put much confidence in Mdme. Secretary’s claims. The developers of the law want IPAB left in the law in the hopes that they can expand on it later on. They can claim that is “irrelevant” all they like, but that isn’t what they have in mind for IPAB to become…a means of usurping the authority of both the legislative and the judicial branch of government.

Please take note that IPAB will be given the power to control all payment rates, both public and private, for health care services. Also note that the power IPAB has will extent into other aspects of Obamacare, including payment rates for those covered under the public health insurance exchange as well as Medicare and Medicaid. If IPAB so chose, they could restrict payment rates for any type of health service, thereby causing rationing to take place under any type of health insurance.

In light of everything that is going on right now regarding the debt ceiling limit battle, it is the utmost of hypocrisy for Democrats, who were the ones primarily responsible for ensuring that excessive control mechanisms were incorporated into the Obamacare, to even try to at this point to paint Republicans as the villains.

They have their own plans to “gut” our health care system in place and have had such for over a year now.

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