The Independent Payment Advisory Board, (IPAB,) is a new federal government panel forming with absolute power. Their job is to lower the overall cost of the Medicare program. The fifteen member panel will be appointed by the president and approved by the Senate, and has no requirement to be bipartisan. No reviews, notices, comments by the public are allowed. Whatever IPAB dictates becomes law, only Congress having the ability to intervene. But the ability of Congress to intervene is quite limited, Obamacare states that they have a limited time to challenge an IPAB ruling, and can only reverse a ruling with three-fifths of their members voting for such action. This is tougher than a proposal amending the Constitution requiring two-thirds of Congress voting in the affirmative. Challenging an IPAB ruling in court? No, the law states that IPAB rulings cannot be challenged in court. What if newly elected officials want to repeal the IPAB panel? Not so fast. Any bill to repeal IPAB must be introduced within the month of January, 2017, and will not be allowed at any other time. (Remember, we need to pass Obamacare so that we can see what’s in it.) If the repeal is successful it cannot go into effect until 2020.
That’s a lot of power for fifteen people, what do they do exactly? This panel’s directive is to control spending within Medicare. Sounds great, everyone knows something must be done about the multi-trillion dollar shortfall this program faces over the next few decades. But IPAB, with all of their power, cannot look to increasing premiums or co-pays of policyholder’s, it is the law. The law also states that IPAB cannot change eligibility requirements or benefits covered, and they cannot ration care. They are directed to save billions of dollars though, and there is only one way left to do so… cut doctor’s pay. Of course this has been tried many times, resulting in the semi-annual, “Doctor Fix.” Physicians already lose money on Medicare patients, collecting ninety-one cents on the dollar. Cutting their pay even more will simply result in more doctors refusing to care for Medicare patients, a form of rationing care if ever there was one.
There is a little hope though, the Goldwater Institute is challenging the constitutionality of IPAB. The Supreme Court has a history of overturning these delegations of power, as it rightly should in this case.
Michael Higgins