Health and Human Services Secretary Kathleen Sebelius has the unilateral power under Obamacare to set Medicare price controls should the Independent Payment Advisory Board fail to submit its own proposal, a Congressional Research Service memo confirms.
IPAB is the signature health care cost-control device of Obamacare. If Medicare spending grows faster than specific targets set by the law, IPAB is empowered to reduce payments to health care providers or eliminate coverage for specific treatments and procedures entirely. Congress would need a three-fifths majority to overturn IPAB’s cost-control measures.
The members of the IPAB are supposed to be appointed by the President and subject to Senate confirmation. But the law also requires the President to get recommendations for appointments from the majority and minority leaders of the Senate and the House Speaker and minority leader. House Speaker John Boehner, R-Ohio, and Senate Republican Leader Mitch McConnell, R-Ky., sent a letter to President Obama last week informing him that they would not be making IPAB recommendations.
If IPAB fails to make Medicare recommendations, for whatever, reason, then the HHS secretary is empowered to submit her own plan, and it would enjoy the same fast-track powers as an IPAB-submitted plan. A CRS memo written to Sen. Tom Coburn, R-Okla., concludes:
In short, should the IPAB fail to submit a package of recommendations in a required submission year, the Secretary is obligated by law to do so. In either event, such legislation would be governed by the “fast track” procedures established by the Act.
As former HHS Secretary Mike Leavitt has said, Obamacare “puts more power than is prudent in the hands of one person.”