Letter: Beware IPAB In Obamacare

Is IPAB another type of iPad? Unfortunately, it is not. IPAB, or Independent Payment Advisory Board, is an un-elected, 15-member federal government agency created by the Affordable Care Act, a.k.a. Obamacare, under sections 3403 and 10320 of the law.

IPAB replaces Congress’ MedPAC agency. MedPAC was created in 1997 as part of the Balanced Budget Act. MedPAC recommends changes to Medicare and Medicaid in order to control the cost of healthcare. Congress must then pass legislation to implement MedPAC’s recommendations. Passing a new law requires: 1) public hearings where various committees hear comment; 2) bipartisan agreement; 3) passage by the Senate and the House; and 4) the president’s signature.

On the other hand, ObamaCare gives IPAB the power to implement “policies” that have the power of a “law” without the Congress, the President or you and I involved. If the Congress does not like the new IPAB “policy,” a.k.a. law, the Congress is required to have a super-majority vote to overturn it.

IPAB will also implement a form of the U.K.’s special health authority called NICE, National Institute for Health and Clinical Excellence. NICE determines the value of using scarce medical resources to manage healthcare costs. Rahm Emanuel, Obama’s first chief of staff and current mayor of Chicago, enlisted his brother, Dr. Ezekiel Emanuel, a medical ethicist, to help write sections of the Affordable Care Act. The value of human life is part of Dr. Emanuel’s contribution. In his book, The Ends of Human Life, Emanuel evaluates the cost of keeping terminally ill patients alive compared with the quality of such a life. The U.K.’s NICE board uses a quality-adjusted life year (QALY) to determine how much care someone is due as they age. Like the U.K.’s QALY, IPAB has the authority to enact “policies” for the level/amount of healthcare available to each person during their lives. Educated young adults are more valuable to society and are thereby eligible for more healthcare than retirees or the young. ObamaCare discourages doctors from unnecessary tests and procedures. IPAB will determine which tests and procedures are “necessary” on an age-appropriate basis.

If the Secretary of Health and Human Services fails to appoint anyone to IPAB, Secretary Kathleen Sebelius can implement “policies” on her own. Like the EPA, which implements air and water standards without the legislative process, in 2013 HHS will have the power to implement health standards. For example, let’s say Secretary Sebelius believes that 16 oz. sugar-laden beverages are “unhealthful.” In 2013, IPAB can implement a “policy” that limits the serving size of “unhealthful” beverages. What could be next? Limits on the amount of time spent watching TV? What about mandatory participation in daily workouts?

If ObamaCare is not repealed, IPAB will have power over nearly all aspects of everyone’s life. The progressives will be in control of a “nanny state” with absolute power. The questions are simple. Do you trust the healthcare “policies” of an un-elected board, or do you trust your personal physician? Do you trust a government that believes the U.S. Constitution is outdated and needs to be replaced, i.e. progressives, or do you believe that “we the people” want a government that believes in fiscal responsibility, limited government and free markets?

Dennis Lipp
Loxahatchee Groves


  1. Great letter! There is so much more about ObamaCare that was intentionally designed to NOT become effective until AFTER this Presidential election and so much that has nothing to do with “health care” but rather government control! It was ruled as a TAX by the SCOTUS, and it is the hardworking middle class who will suffer the greatest consequence under this bill if it is not repealed. I wonder if Obama supporters know that over 500,000 union members and their leaders asked for an exclusion from ObamaCare (which was granted to them) because of the enormous cost, even after they supported the bill to help get it passed? Future jobs loss numbers will be enormous, especially in the private sector and our country will decline as never before. I pray that those uninformed people will do themselves and our country a favor by making it their mission to learn more BEFORE they blindly vote for a man who has failed America! Romney will repeal most of ObamaCare. Romney-Care was designed for an individual state(s), not a national government takeover! Romney and Ryan are well qualified to save this country.

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