Christina Sandefur

Fifteen Bureaucrats Are Better Than One

Posted on May 30, 2013 | Author: Christina Sandefur
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Speaker of the House John Boehner (R-OH) and Senate Minority Leader Mitch McConnell (R-KY) have announced that they will not recommend candidates to serve on the Independent Payment Advisory Board, the federal health care law’s panel of 15 bureaucrats tasked with reducing Medicare costs. In a letter to the president explaining their decision, Boehner and McConnell said they “believe Congress should repeal IPAB” and “hope establishing this board never becomes a reality.”

The Board has vast power over the entire health care market to set price controls, levy taxes, and even ration care. In fact, it can propose anything its members determine is “related to the Medicare program.” IPAB’s proposals automatically become law unless Congress and the president quickly enact a substitute plan with an equal reduction in spending, and the Board’s decisions aren’t subject to review by administrative judges or courts. To add insult to injury, the Board is virtually unrepealable.

The Goldwater Institute is suing over the constitutionality of the Board, arguing that it is a violation of the Constitution’s separation of powers doctrine. Lawmakers are right to call for its demise. But will refusing to recommend board members do the job?

No. While the president must seek recommendations from Congress, the ultimate decision of whom to appoint to the Board is his. And there’s no requirement that IPAB be bipartisan. So refusing to participate in the appointment process just gives President Obama more say in the Board’s makeup.

Worse yet, stalling member appointments and confirmations may mean no one gets chosen for IPAB. To opponents of the Board, that may sound desirable. But as the Congressional Research Service recently confirmed, if no one is selected to fill the board member slots, the Secretary of Health and Human Services will wield IPAB’s powers unilaterally.

While lawmakers should work to repeal IPAB, washing their hands of the appointment process is a step in the wrong direction. When it comes to making health care decisions, the only thing worse than 15 unelected, unaccountable bureaucrats is one unelected, unaccountable bureaucrat.

Learn more:

Washington Examiner: Republicans refuse appointments to Obamacare rationing board

Letter to President Obama from Speaker Boehner and Senator McConnell

CRS memo

Goldwater Institute lawsuit: Coons v. Geithner

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