Since its inception, <a href="http://www.nytimes.com/2011/04/20/us/politics/20health.html?nl=us&amp;emc=politicsemailema1&amp;utm_source=huffingtonpost.com&amp;utm_medium=referral&amp;utm_campaign=pubexchange_article">bipartisan opposition</a> has existed to the Independent Payment Advisory Board (IPAB), an Obamacare relic with the authority to make changes to Medicare policy. However, President Trump&#8217;s fiscal year 2018 budget, &#8220;<a href="https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/budget/fy2018/budget.pdf">A New Foundation For American Greatness</a>,&#8221; may finally do something about it.
IPAB&#8217;s sole purpose is to propose yearly cuts to Medicare spending. The board is composed of 15 bureaucrats appointed by the President, all of whom are subject to Senate confirmation &#8212; however, this largely represents the extent of the board&#8217;s subordination to Congress.
When the board submits a proposal to Congress, it <a href="https://www.cato.org/publications/policy-analysis/independent-payment-advisory-board-ppacas-anticonstitutional-authoritarian-superlegislature">unilaterally becomes law</a>, as the Secretary of Health and Human Services is legally required implement it. In order for Congress to block one of these proposals, the House, Senate, and President are required to provide a replacement. IPAB is essentially exempt from the political process, which is why both Democrats and Republicans alike oppose it.
As for cutting costs, the board is <a href="https://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf">expressly prohibited</a> from including, &#8220;any recommendation to ration health care.&#8221; While this sounds great on paper, its real-life ramifications are severe. IPAB&#8217;s <a href="http://dailycaller.com/2017/05/29/a-consensus-to-repeal-obamacares-medicare-bureaucracy/">only two options</a> to reduce spending are to cut payments to healthcare providers, or deny access for certain treatments, classifying them as, &#8220;Not Cost Effective.&#8221;
Unfortunately, this ultimately amounts to rationing healthcare, which is why more than 600 national and state organizations <a href="http://protectmydoctorandme.com/2016/11/29/more-than-600-national-and-state-organizations-call-on-congress-to-repeal-the-independent-payment-advisory-board/">called on Congress</a> to repeal the Independent Payment Advisory Board in November of 2016, including patients, employers, veterans, and minority groups.
Neurosurgeon Dr. Alex B. Valadka, a spokesperson for the Alliance of Specialty Medicine <a href="http://wp.vcu.edu/som-dean/2015/04/alex-valadka-m-d-named-chair-of-the-department-of-neurosurgery/">named</a> the chair of the Department of Neurosurgery at Virginia Commonwealth University in 2015, believes the board threatens seniors&#8217; access to medical care.
&#8220;With the advent of IPAB, the people&#8217;s elected representatives will no longer have power over Medicare payment policy,&#8221; Valadka <a href="http://thehill.com/blogs/pundits-blog/healthcare/320631-ipabs-medicare-cuts-will-threaten-seniors-access-to-care">wrote</a>, stating, &#8220;instead, these major health policy decisions will rest in the hands of 15 unelected and largely unaccountable bureaucrats, with little or no clinical expertise or the oversight required to protect access to care for our country&#8217;s seniors.&#8221;
&#8220;As a neurosurgeon who treats Medicare patients, I consider the IPAB to be one of the most insidious elements of the Affordable Care Act (ACA), and it needs to go,&#8221; Valadka concluded.
Thankfully, President Trump&#8217;s White House fiscal budget states that it will, &#8220;Repeal the Independent Payment Advisory Board (IPAB).&#8221; Republicans, Democrats, conservatives, and progressives alike oppose the IPAB for good reason &#8212; it replaces your doctor with a federal bureaucrat who decides your care.
It&#8217;s high time that Congress should cut this exercise in government bureaucracy.
Mitchell Gunter is a contributor to publications such as the Daily Caller, Heat Street, and FEE. His work has been cited by national outlets, including Tucker Carlson Tonight, National Review, the Washington Times, and the New York Post.
You can follow Mitchell on Twitter at <a data-saferedirecturl="https://www.google.com/url?hl=en&amp;q=https://www.twitter.com/rMitchellGunter&amp;source=gmail&amp;ust=1498131546314000&amp;usg=AFQjCNHYlT4MV6qq6OSYjgZYCB4y0vE-Fg" href="http://www.twitter.com/rMitchellGunter" target="_blank" rel="noopener noreferrer">www.twitter.com/rMitchellGunter</a>&#8220;
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Trump Takes Aim At Obamacare’s Anti-Constitutional Medical Insurance Board

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Trump Takes Aim At Obamacare’s Anti-Constitutional Medical Insurance Board