A Behind-the-Scenes Look at the Dem Plan to Bring ObamaCare to Medicare

June 16, 2011

Board of Unelected, Unaccountable Bureaucrats Created by ObamaCare Now Empowered to Cut Medicare

  • President Obama empowered a board of unelected, unaccountable bureaucrats created in ObamaCare to cut Medicare.
  • These bureaucrats, known as the Independent Payment Advisory Board, or IPAB, will collect a six-figure salary, and won’t even need a medical degree to make decisions that would interfere with doctors and limit seniors’ access to care.
  • Even some Democrats and groups who ardently supported ObamaCare oppose Obama’s expansion of IPAB’s powers to bring ObamaCare to Medicare.




President Obama’s Medicare plan empowers a board of unelected, unaccountable bureaucrats to cut Medicare. Members of IPAB would be paid a cushy salary of more than $165,000 annually for six years, but they wouldn’t even need a medical degree to decide which services and procedures to cut, cuts which would interfere with doctors and limit seniors’ access to care:


OBAMA’S MEDICARE PLAN: EMPOWER “15 SAGES” WITH “THE POWER OF THE PURSE”: “Fifteen members will serve on the Independent Payment Advisory Board, all appointed by the President and confirmed by the Senate. If per capita costs grow by more than GDP plus 0.5%, this board would get more power, including an automatic budget sequester to enforce its rulings. So 15 sages sitting in a room with the power of the purse will evidently find ways to control Medicare spending that no one has ever thought of before and that supposedly won’t harm seniors’ care, even as the largest cohort of the baby boom generation retires and starts to collect benefits.”(Editorial Board, “The Presidential Divider,” The Wall Street Journal, 4/14/2011)


BUREAUCRAT BOARD MADE EVEN STRONGER THAN UNDER GOVERNMENT HEALTHCARE TAKEOVER: “The president, for his part, answered Ryan’s budget by proposing an even stronger version of the board than the health reform law created.” (Jennifer Haberkorn, “Medicare Pay Board Is Losing Vital Support,” Politico, 6/8/2011)

NOT A DOCTOR? DON’T WORRY ABOUT IT: “The appointment membership of the board shall include (but shall not be limited to) physicians and other health professionals, experts in the area of pharmaco-economics or prescription drug benefit programs, employers, third-party payers, individuals skilled in the conduct and interpretation of biomedical, health services, and health economics research and expertise in outcomes and effectiveness research and technology assessment. Such membership shall also include representatives of consumers and the elderly.” (p. 402, “Sec.3403. Independent [Medicare] Payment Advisory Board,”Patient Protection and Affordable Care Act, 5/3/2010)


IPAB MEMBERS CAN SERVE UP TO TWELVE YEARS, OR TWO SIX YEAR TERMS, WITHOUT EVER FACING VOTERS: “Terms are for six years, and members may serve no more than two consecutive terms.” (Jack Ebeler, Tricia Neuman, and Juliette Cubanski, “The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending,” The Henry J. Kaiser Family Foundation, April 2011)


ALL WHILE RECEIVING A TAX-PAYER FUNDED SALARY OF $165,300/YEAR:“IPAB members are paid at a rate prescribed for level III of the Executive Schedule, which is $165,300 in 2011.” (Jack Ebeler, Tricia Neuman, and Juliette Cubanski, “The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending,” The Henry J. Kaiser Family Foundation, April 2011)


WSJ: OBAMA MEDICARE PLAN IS MEDICARE “RATIONING”, WILL “THROW GRANNY OVER THE CLIFF”: “One place to start is by attacking the Democratic plan to cut Medicare via political rationing. Mr. Ryan’s budget had the virtue of embarrassing President Obama’s spend-more initial budget, and the White House responded by proposing to increase the power of the new Independent Payment Advisory Board (IPAB) to decide what, and how much, Medicare will pay for. The ObamaCare bill goes to great lengths to shelter this 15-member, unelected board from Congressional review, with the goal of letting these bureaucrats throw granny over the cliff if Medicare isn’t reformed. Yet few Americans know anything about IPAB or its rationing intentions.” (Editorial, “The GOP’s New York Spanking,” The Wall Street Journal, 5/26/2011)


Obama’s choice to greatly expand IPAB’s powers and apply ObamaCare to Medicare has even met opposition from a few of his fellow Democrats. Among them are Rep. Allyson Schwartz (D-PA), a member of the leadership of the House Democrat’s campaign committee, and offensivebraying Democratquote machine Rep. Pete Stark (D-CA), a senior member of the powerful House Ways and Means Committee, who described Obama’s board of bureaucrats as a “mindless-rate cutting machine” that “will endanger the health of America’s seniors and people with disabilities”:


REP. SCHWARTZ SAYS OBAMA’S MEDICARE BOARD WILL “CUT PAYMENTS” AND SHOULD BE REPEALED: “We all agree that Medicare costs must be contained and that the payment system is flawed and needs to be replaced. But simply cutting reimbursements is not the answer. IPAB brings unpredictability and uncertainty to providers and has the potential for stifling innovation and collaboration.


“The threat of reduced payments is the least imaginative option and most unlikely to result in the kind of heath care we know seniors and all Americans deserve.


“We have a choice: Reduce costs through improved delivery of care or simply leave it to this new board to cut payments.” (Rep. Allyson Schwartz, “Opposing View: Repeal Medicare Board,” USA Today, 5/23/2011)


REP. STARK: IPAB IS A “MINDLESS-RATE CUTTING MACHINE THAT SETS THE PROGRAM UP FOR UNSUSTAINABLE CUTS”: “I oppose the inclusion the Independent Payment Advisory Commission, called IPAB.  Some of my colleagues support this Commission because it shields them from having to take tough votes when it comes to cutting Medicare provider payments. It’s my experience that Congress always does what is needed to protect and strengthen the Medicare program.  IPAB is a dangerous provision.   By statute, this Commission would be required to hold Medicare spending to an arbitrary and unrealistic growth rate.  It is a mindless-rate cutting machine that sets the program up for unsustainable cuts. That will endanger the health of America’s seniors and people with disabilities.  It is an unprecedented abrogation of  Congressional authority to an unelected, unaccountable body of so-called experts.  I intend to work tirelessly to mitigate the damage that will be caused by IPAB.” (“Statement of Congressman Pete Stark Supporting Health Care Reform,” Office of Rep. Pete Stark, 3/21/2011)


These Democrats and others who count themselves among ObamaCare’s most ardent Democrat supporters are having second thoughts as President Obama applies ObamaCare to Medicare by expanding IPAB’s power. A growing number of Democrats are calling for repeal of this unelected and unaccountable board of bureaucrats empowered to cut Medicare and threaten seniors’ access to care:


FORMER REP. RON KLINK (D-PA) SAYS IPAB “IS DEMOCRATS’ ACHILLES’ HEEL,” WILL “GUT MEDICARE”: “Medicare, Medicaid, and healthcare in general are the issues that Democrats hope to ride to victory in the polls in 2012. … But we could easily lose this edge when the public figures out that many Democrats support or at least don’t oppose a poorly conceived bureaucracy created under the new healthcare law that will accomplish the same thing they accuse the Ryan plan of doing, gutting Medicare.” (Ron Klink, “IPAB Is Democrats’ Achilles’ Heel,”The Hill, 6/15/2011)


SEVEN DEMOCRATS SIGN ON TO REPEAL IPAB—AND COUNTING: “According to Politico, a bill introduced by Rep. David Poe, R-Tenn., to repeal IPAB has seven Democrat co-sponsors. Thus far IBD has only been able to track down five: Allyson Schwartz, Pa.; Linda Sanchez, Calif.; Kathy Castor, Fla.; Michael Capuano, Mass.; and Shelley Berkley, Nev.” (David Hogberg, “IPAB Is Really, Really Doomed,” Investor’s Business Daily’s Politics and Markets Blog, 6/9/2011)


LEFT-WING GROUP: “IPAB TURNS MEDICARE INTO A SCAPEGOAT”: “The National Committee to Preserve Social Security and Medicare, a prominent supporter of the law, is now actively lobbying for its repeal, too. …


“For more than a year, the National Committee and other supporters of the reform law who didn’t like the IPAB were willing to put up with it for the greater good of the law. But in recent weeks, that support has waned.


‘IPAB turns Medicare into a scapegoat,’ said Max Richtman, executive vice president and acting CEO of the National Committee to Preserve Social Security and Medicare. ‘Medicare will be forced to make reductions without addressing the rest of the health care costs.’” (Jennifer Haberkorn, “Medicare Pay Board Is Losing Vital Support,” Politico, 6/8/2011)


With friends like these, who needs enemies? It’s no wonder a job on IPAB is already being pinned as the “worst in D.C.” No one wants to be in charge of slashing Medicare for seniors. When will other House Democrats join Republicans to oppose President Obama’s plan to apply ObamaCare to Medicare?:


“MEDICARE COST-CUTTING JOB COULD BE WORST IN D.C.”: “Wanted: nationally known health care experts to serve on controversial health care board that will make painful Medicare spending cuts.


“Must be willing to quit current job to do it. Also, must be willing to go through bloody and humiliating confirmation fight.


“That’s the job description for the 15 members of the Independent Payment Advisory Board — the new panel created by President Barack Obama’s health care law to come up with ways to cut Medicare spending if it grows too fast.”(David Nather, “Medicare Cost-Cutting Job Could Be Worst in D.C.”, Politico, 5/14/2011)