The Senate’s decision to go “nuclear” breathes new life into a dormant but extremely controversial part of Obamacare.
The Senate’s rules change will likely make it much easier for President Obama to fill the Independent Payment Advisory Board, or IPAB — a 15-member panel tasked with slowing the growth in Medicare spending. The IPAB is a polarizing piece of the Affordable Care Act: It’s been a feature of GOP campaign ads, and the House has voted to repeal it.
The IPAB is technically supposed to submit its first proposed cuts in January, but Obama hasn’t even nominated anyone to the board yet. Nominees have to be confirmed by the Senate, which until today required 60 votes — and Republicans were highly unlikely to help confirm anyone to the board.
But now that the Senate has moved to a 51-vote threshold for executive appointments, Obama will likely be able to fill the board and move ahead with one of the most significant cost-control measures in his signature health care law — if he wants to.
A GOP Senate aide confirmed that the rules change will apply to IPAB nominees; spokespeople for Majority Leader Harry Reid, D-Nev., and the White House did not respond to questions about the rules change and the health care board.
Obama might not want to appoint anyone to the IPAB before next year’s midterms, even if he could get them confirmed more easily. The nominations would certainly trigger a fresh debate over his health care law and its cuts in Medicare spending.
Plus, Medicare’s trustees say the program’s costs are growing so slowly on their own that the IPAB wouldn’t even be triggered until at least 2015. The IPAB’s charge, under the Affordable Care Act, is to make targeted cuts in Medicare’s payments to doctors and health care providers if the program’s overall costs grow faster than a certain rate.
Technically, the board only recommends cuts to Congress, but the process is structured so that its cuts are highly likely to take effect. Congress has to proactively block the IPAB’s recommendations and come up with equivalent savings somewhere else in the budget.
GOP critics oppose the IPAB largely because it puts the power to set Medicare payments in the hands of unelected experts. Supporters say that’s exactly the point: Congress lacks the political will to actually make meaningful cuts to doctors, hospitals, and other providers, so an administrative panel is the only way to control Medicare’s costs.
Republicans are also afraid that the IPAB will “ration” care. The law prohibits the board from “rationing,” and it is not allowed to cut seniors’ benefits — only providers’ payments. But critics say the board will drive payments so low that doctors in certain fields will quit accepting Medicare payments.
The policy is popular with a large number of academics and health care wonks — it was the pet project of Peter Orszag, who led the White House budget office during the health care debate. But doctors, pharmaceutical companies, and other health care providers strongly support repealing the board.
What We're Following See More »
"An emerging government funding deal would see Democrats agree to $15 billion in additional military funding in exchange for the GOP agreeing to fund healthcare subsidies, according to two congressional officials briefed on the talks. Facing a Friday deadline to pass a spending bill and avert a shutdown, Democrats are willing to go halfway to President Trump’s initial request of $30 billion in supplemental military funding."
The Michael Flynn story is not going away for the White House as it tries to refocus its attention. The White House has denied requests from the House Oversight Committee for information and documents regarding payments that the former national security adviser received from Russian state television station RT and Russian firms. House Oversight Chairman Jason Chaffetz and ranking member Elijah Cummings also said that Flynn failed to report these payments on his security clearance application. White House legislative director Marc Short argued that the documents requested are either not in the possession of the White House or contain sensitive information he believes is not applicable to the committee's stated investigation.
The Washington, D.C. area will undergo "a full-scale exercise" Wednesday morning "designed to prepare for the possibility of a complex coordinated terror attack in the National Capital Region." The drill will take place at six different sites throughout the District of Columbia, Maryland, and Virginia. The drill should not be taken as a sign that emergency services are expecting an attack, said Scott Boggs, Managing Director of Homeland Security and Public Safety at the Metropolitan Washington Council of Governments.
The Presidential Inaugural Committee "acknowledged late Monday that a final report it filed with the Federal Election Commission this month was riddled with errors, many of which were first identified through a crowdsourced data project at HuffPost." The committee raised about $100 million for the festivities, but the 500-page FEC report, which detailed where that money came from, was riddled with problems. The likely culprit: a system of access codes sent out by the GOP's ticketing system. Those codes were then often passed around on the secondary market.