A rising chorus of repeal-mongers, outraged at the Obama administration’s federal health care power grab, took over Washington this week. Nope, it’s not the tea party. It’s Democrats Against the Independent Payment Advisory Board (IPAB). Yes, Democrats.
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.
Last month, Health and Human Services Secretary Kathleen Sebelius touted IPAB as a “key part” of Obamacare. The president himself crusaded for giving the board even more regulatory “tools” to usurp congressional power over health care allocations. And he has the audacity to blame Republicans for creating a “banana republic”? Hmph.
The conservative Arizona-based Goldwater Institute has filed suit in federal court to stop 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. But it’s the growing opposition from members of the administration’s own party that may yet doom these health care czars on steroids.
But look who’s not biting: According to Politico, “New Jersey Rep. Frank Pallone, of the Energy and Commerce health subcommittee, has zero interest in defending the board. ‘I’ve never supported it, and I would certainly be in favor of abolishing it.'” If that’s not clear enough, Pallone added that he’s “opposed to independent commissions or outside groups playing a role other than on a recommendatory basis.” Period.
Another House Democrat, Allyson Schwartz of Pennsylvania, is one of seven Democratic IPAB repeal co-sponsors and is scheduled to testify Wednesday at a second House hearing blasting the board. And former Democratic House Majority Leader Dick Gephardt channeled the tea party in a recent op-ed when he decried IPAB as “an unelected and unaccountable group whose sole charge is to reduce Medicare spending based on an arbitrary target growth rate.”
IPAB defenders demand an alternative, but that’s why the Medicare Payment Advisory Commission already exists. And for those unsatisfied with its woeful results, there’s the demonized GOP/Rep. Paul Ryan reform package that relies on individual choice and competition over bureaucratic diktats to reduce spiraling Medicare costs.
Opponents of GOP structural reforms have now resorted to decrying Ryan’s choice of beverages as a way to discredit the plan. An apparently besotted Rutgers University economist and former Kerry/Edwards economic adviser, Susan Feinberg, accosted Ryan at a D.C. restaurant last week while he was dining with two financial experts over a pricy bottle of wine. “I wasn’t drunk, but I was certainly emboldened to speak my mind,” Feinberg told liberal blog Talking Points Memo. She gleefully described attacking Ryan for espousing government austerity while — gasp — dining out on his own dime.
It’s the same unhinged and irrational sanctimony that has New York Times columnist David Brooks assailing entitlement reformers as moral degenerates; the Washington Post’s Richard Cohen likening them to Jonestown cult killer Jim Jones; and Daily Beast editor Tina Brown decrying them as “suicide bombers.” Ah, the days of whine and bozos.
The good news: Thanks to sober bipartisan criticism (Where are all the cheerleaders for bipartisanship when you need them?), Sebelius and company are now downplaying IPAB as a harmless “backstop mechanism” with limited powers to do anything at all to control costs. At a House hearing Tuesday, Sebelius tried to paint the board as just another run-of-the-mill dog-and-pony panel that would be “irrelevant” if Congress so chooses
It’s not quite an under-the-bus moment, but it’s certainly a nudge toward rolling back the Obamacare Republic.