Why IPAB Should Be an Election Issue

Last week the U.S. House Energy and Commerce Committee held a lengthy hearing on the subject of ObamaCare's Independent Payment Advisory Board (IPAB). The hearing included four panels and featured nationally recognized healthcare experts, as well as Members of Congress who are opposed to IPAB. The board is a great source of controversy and has become a political liability for the Democrats because of the vast powers it will wield and because of the way the board will operate, largely unchecked by the other branches of government.

Section 3403 of the Patient Protection and Affordable Care Act (ObamaCare) creates a commission, commonly referred to as IPAB, empowered to help contain Medicare costs. IPAB will have fifteen members appointed by the President without Senate confirmation; the board members will hold their posts for terms of varying length, ranging from one to six years. The commission's decisions are not subject to judicial review and, alarmingly, the commission has no obligation to engage in public notice, which is usually required of regulatory agencies that have similar decision-making authority. Furthermore, the only way that Congress can override the board's decisions is with a super-majority vote of three-fifths of the House and three-fifths of the Senate. Without an override vote from Congress, the board's decisions become law. In short, the bureaucratic commission effectively has the power to legislate and is at no point accountable to voters.

As Americans have learned more about this board's structure and its sweeping authority, they have begun to voice their opposition. Even some Democrats are beginning to realize the political danger of supporting this type of commission; several Democrats in the House are currently backing Republican legislation to repeal the board.

Given the board's lack of public support, Republicans would do well in 2012 to make IPAB an election issue and to remind voters that this board is the brainchild of Democrat politicians. Beyond its dangerous policy implications, IPAB is also significant because of the ways in which it provides a glimpse into the way liberals approach governance. IPAB, in many ways, is the perfect embodiment of the modern liberal philosophy.

The first insight to be gained by studying IPAB is that modern Democrats possess an absolute confidence in the ability of ruling elites to engineer major elements of society. The Democrats who wrote ObamaCare seem to believe that a board of fifteen Presidential appointees meeting behind closed doors will better be able to solve our nation's Medicare and entitlement crises than would democratically-elected Members of Congress. This preference to pass decision-making authority to unelected bureaucrats reveals the extent to which Democrats believe government is best left in the hands of elite rulers, rather than allowing voters to have their voices heard.

The Constitution clearly calls for a representative government, not a government of "experts" whose opinions and decisions become law as a matter of course and cannot be appealed or challenged in court. But by creating IPAB, Congressional Democrats have reminded us how little regard they have for the Constitution's system of representative democracy and the principle of judicial review.

Another important insight about liberals that becomes apparent through IPAB is that Democrats believe government is always the solution. Even when the problem is itself created by government (as it is in the case of Medicare), more government is, nevertheless, the answer. For the liberal mind, it poses no logical conundrum that government has failed for five decades to contain Medicare's costs, and that the solution Democrats in Congress have proposed is… more government.

IPAB further illustrates that Democrats are not as interested in solving our nation's major policy problems as they are in accomplishing their agenda. In the past few months, several economists and healthcare policy experts have demonstrated that IPAB will not be able to effectively curb Medicare costs. And yet, in spite of the mounting evidence, the majority of Democrats remain steadfastly committed to implementing the board. Why? At their core, ObamaCare and IPAB do not aim to improve healthcare policy; instead, the healthcare overhaul and IPAB's panel of bureaucrats serve the Democrats' overarching objective of transforming the relationship between the individual and the federal government. IPAB and ObamaCare advance the liberal agenda of subordinating individual autonomy to the wishes of the government.

Finally, IPAB reveals that Democrats fail to appreciate the important role that democratically-elected representatives should play. Instead, Democrats prefer to give major decision-making authority to unelected and unaccountable bureaucrats. Late last month, 270 organizations across the country wrote a joint letter to Congress to express their support for repealing IPAB. In the letter, these organizations articulate the primary problem with the way Congress has passed its duty to legislate to an unelected commission:

"Congress is a representative body that has a duty to legislate on issues of public policy. Abdicating this responsibility to an unelected and unaccountable board removes our elected officials from the decision-making process for a program that millions of our nation's seniors and disabled individuals rely upon."

IPAB tells us everything we need to know about modern liberals' philosophy of governance. Voters need to remember on Election Day that this board – with its sweeping authority and extra-Constitutional legislative powers – is the quintessential liberal policy.

Shonda Werry is a former Capitol Hill staffer at the Senate Republican Conference with extensive policy experience. She blogs on ObamaCare and other healthcare issues at www.healthcare-coalition.org.