ObamaCare’s Independent Payment Advisory Board: An Extra-Legal 4th Branch of the Government

A recent article in the Wall Street Journal, entitled “An ObamaCare Board Accountable to No One,” sheds light on disturbing new details surrounding ObamaCare and the group of 15 unaccountable government bureaucrats slated to dictate major health care decisions for the nation – known as the Independent Payment Advisory Board (IPAB).
Members of the IPAB – presidentially nominated and Senate-confirmed – will be responsible for overseeing a half-trillion dollars in federal spending annually while “developing” detailed and specific proposals related to the Medicare program.” In short, the IPAB is charged with enforcing a limit on Medicare spending growth. Though ObamaCare prohibits the board from rationing care, the mandate to cut Medicare can lead to nothing else. Once payments to doctors are reduced, health care providers will have no choice but to limit the number of Medicare patients they see – causing seniors’ access to care to be greatly diminished or foregone completely in some instances. As David Rivkin and Elizabeth Poley astutely observe in their WSJ article, “ObamaCare’s commands to the board are thus inherently contradictory and, consequently, unintelligible.”
Perhaps the most unsettling aspect of the IPAB is the fact that it is accountable to no branch of government. Virtually removed from the Constitution’s separation-of-powers principle, members of the IPAB can only be absolved from the board for neglect or malfeasance. This enables a board in Washington – which is not required to have any training or experience in the medical profession – to make highly consequential decisions about health care delivery in our country without any real oversight or actual debate. Seniors will have no government body to turn to once the weight of the IPAB’s decisions comes to bear.
With government abuse and scandals running rampant in recent days, AMAC firmly believes that a body of unaccountable, unelected individuals should not be endowed with such a vast degree of authority on a program as significant as Medicare. AMAC also believes that by concentrating more power at extra-legal levels of the Federal government – with panels like the IPAB – transparency, accountability, and oversight are significantly reduced, and the vital relationship between patients and their doctors is further eroded.
Some in Congress have raised these concerns before the Health and Human Services Secretary, Kathleen Sebelius, in letters and hearings and have introduced legislation to repeal the IPAB. Yet, no effort to strike the IPAB from ObamaCare has prevailed to date. AMAC pledges to continue to fight against the institution of this unconstitutional panel, as we fully understand the high stakes involved for all Americans – particularly seniors.

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Timothy Hopkins

If you think that a culture that slaughters its babies for convenience or for money won’t slaughter its elderly for the same reasons, then please don’t be surprised when you, your friends, or your family are eventually disposed of by the very bureaucracy charged, ironically, with national health care. Your capital offense, the thing that lowers the death sentence upon you: Getting older and getting expensive. When the choice is between you and money, and when the government has no money, you die. Please notice: the government has no money.


IPAB was part of Obamacare when it was signed into law in 2010. There were even a number of stories written up in a number of either neutral or conservative newspapers and magazines outlining how various parts of Obamacare would work or more to the point, break the existing healthcare system. What was laid out then was terrifying to think of in that any free people would simply stand by and allow the wholesale takeover of the entire healthcare sector. Yet aside from some TEA Party groups, the vast majority of the population either shrugged and went about their day-to-day business or were oblivious to what had just happened. Now we’re in 2013 and months away from this incredibly bad law going live and ruining the healthcare model for the country. Could someone from AMAC please explain to me how is it that so many conservative organizations are just now… Read more »