It Isn’t Just the Mandate
IPAB is where Obamacare careens into lawlessness.

The president with Kathleen Sebelius and Nancy Pelosi (The White House/Pete Souza)


Mona Charen

Call it Nancy Pelosi’s revenge. The Democratic party, supposedly so close to the people, writes legislation to insulate government from democratic accountability.

Starting in 2014, the board will make recommendations to control Medicare spending, but the law prohibits IPAB from recommending (1) rationing of health care, (2) increases in premiums, (3) increases in co-pays or deductibles, or (4) changing eligibility requirements or benefits. What’s left? Reducing payments to doctors and hospitals. This sets up the obvious problem that is already plaguing Medicaid — when doctors and hospitals receive reduced reimbursement, they become less likely to accept Medicare patients. So Medicare patients will find it harder to get treatment, which is, in effect, a form of rationing.

The Goldwater Institute Center for Constitutional Litigation has challenged the constitutionality of IPAB, and based on the Supreme Court’s history of displeasure with delegations of power by Congress (for example in the line-item-veto case), they may have a strong case. But whatever the outcome of these legal cases may be, the effort to get this poisonous hydra repealed — by the elected branches of government — cannot flag.

Mona Charen is a nationally syndicated columnist. © 2012 Creators Syndicate, Inc.