Administration told to submit arguments on Independent Payment Advisory Board
The Supreme Court is telling the Obama administration to present its case for Obamacare’s Independent Payment Advisory Board – the provision that critics have described as a “death panel” – even if it doesn’t want to.
The administration previously had declined to offer comments on the case against IPAB, which, according to the Obamacare law, is unanswerable to Congress and unaccountable to the federal courts.
The panel, given the authority to approve or disapprove payments for services and set the level of payment, was intended to control Medicare costs.
Members of Congress recently submitted a friend-of-the-court brief expressing just how dangerous the panel can be for Medicare recipients.
“We already know what will happen with IPAB. We had experience with something similar in my home state of Tennessee with TNCARE. As reimbursement rates are cut to doctors, access was reduced for the needy. I fear for Medicare recipients,” said Rep. Phil Roe, R-Tenn., a doctor.
Rep. Paul Gosar, R-Ariz., a dentist, said the panel “puts government between me and my patients.”
In a commentary published in the Wall Street Journal, Roe and Sen. Tom Coburn, R-Okla., also a doctor, called IPAB a patient’s nightmare and bad for doctors.
“Why is this board dangerous? Because there is nothing ‘advisory’ about its vast powers. IPAB’s mandate is to deliver on one of Obamacare’s central promises: Medicare cost-containment,” they wrote.
“The law gives this board sweeping authority to do so, with virtually no constraints. The statute says IPAB can take any and all actions necessary to control Medicare costs. Although it is prohibited from ‘rationing,’ that term is nowhere defined in the Affordable Care Act. Hence IPAB can control costs by lowering physician reimbursements – thus driving more doctors away from treating Medicare patients – or by reducing the services eligible for reimbursement. In other words, by rationing care.”
The rationing of care is why, critics say, it is being called a “death panel.” IPAB members would only need to lower physician reimbursement for a particular life-saving procedure to an impossible level, and doctors would be unable to provide the service, meaning some patients could die.
“IPAB will consist of 15 members appointed by the president, all of whom may be from the same party. If the president does not nominate anyone to the board, or if the Senate fails to confirm nominees, IPAB’s powers must be unilaterally exercised by the Health and Human Services secretary. In short, the power to alter Medicare potentially can be consolidated in a single individual,” the two doctors wrote in the Journal.
“Executive agencies ordinarily are subject to open meetings and to notice and comment procedures. Not IPAB. The Affordable Care Act characterizes IPAB’s actions as ‘recommendations.’ This is a misnomer; its recommendations automatically become law unless Congress acts to stop it.
“Finally, the Affordable Care Act insulates IPAB’s decisions from judicial review, thus achieving an unprecedented trifecta of bureaucratic rule: an administrative agency whose actions cannot be checked by the executive, legislative or judicial branches. This setup shreds the separation of powers that is fundamental to the U.S. Constitution, under which no agency can be rendered exempt from democratic processes and the rule of law.”
Written by BOB UNRUH
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