The 2012 election, and the existence of a free health-care market in this country, could well depend on a little-known agency called IPAB. Remember that acronym. It stands for the Independent Payment Advisory Board, a vastly powerful but too often overlooked component of the president’s health-care-reform law. IPAB has not yet come into existence, but when Obamacare goes into full effect, it will be an unelected and unaccountable bureaucratic entity with nearly limitless power over federal Medicare spending. IPAB will have the power to effectively ration health care through price controls — which may not even be the scariest thing about it. That distinction arguably falls to its unprecedented overriding of congressional sovereignty, in flagrant violation of the constitutional separation of powers.
President Obama won’t admit to any of this, of course, but his nationally televised April 13 speech in response to Paul Ryan’s deficit-reduction plan did push IPAB out of the shadows and into public view. Obama made clear in that speech that IPAB’s authority over Medicare pricing would be a central component of his deficit-reduction plan, and he used the occasion to call for a substantial expansion of IPAB’s already unprecedented powers.
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