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“Nuclear Option” Only Adds a Can of Worms to the IPAB Debate

By December 2, 2013Medicare

Recently, the Senate approved a significant rule change which eliminates the use of the filibuster on all Presidential nominees except for the U.S. Supreme Court. In a nutshell, the Senate’s passage of the so-called “nuclear option” now allows executive branch and judicial nominations to be approved with a simple majority – 51 votes — rather than the 60 votes that was previously required.

Certainly, the decision to go “nuclear” will make bipartisan deals more difficult to attain and it may result in a shift of power away from the legislative branch and to the executive. With this in mind, it begs the question how will the decision to go “nuclear” effect the nomination of individuals to the Independent Payment Advisory Board (IPAB)?

For those folks who might be new to this topic, the IPAB was created by the Affordable Care Act (ACA), and is a board of 15 unelected and largely unaccountable government bureaucrats whose primary purpose is to cut Medicare spending. In order to serve on the IPAB, nominees have to be confirmed by the Senate, and with the newly invoked “nuclear option,” the confirmation process is theoretically much easier.

To this end, we wanted to highlight two outstanding articles written on this very topic:

  • Sam Baker of the National Journal makes the  that the “nuclear option” does in fact breathe new life into the IPAB by making it much easier for President Obama to appoint its 15 members.
  • Michael Cannon with Forbes raises a very valid point and discusses that although the “nuclear option” makes the process of appointing people much easier for the President, Obama doesn’t need to appoint anyone to the board. If the IPAB fails to make Medicare recommendations, for whatever reason, then the HHS secretary is empowered to submit her own plan in lieu of the IPAB.

The bottom line is this:  Whether the IPAB allows the HHS Secretary or 15 unelected and largely unaccountable government bureaucrats to arbitrary cut Medicare spending, the outcome will be the same — seniors will have less access to care.

We have said it before; bad policy is just bad policy. IPAB, coupled with the “nuclear option,” really only accomplishes one thing:  adding a can of worms to bad policy. This is exactly why organized neurosurgery continues to press Congress to repeal the IPAB, which in the future will STILL have the power to haphazardly cut billions of dollars from Medicare.

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