One Health To Rule Them All


In the last post, I likened the Independent Payment Advisory Board to the Ringwraiths in Tolkien’s epic fantasy trilogy. The reader may find this humorous but consider a secret order of rule makers given autonomy by one individual, the President, with the sole purpose of implementing his agenda shielded from any question or interference and the analogy takes on a more serious nature. The fact that IPAB wields so much power with no oversight, checks or balances should strike dread into the very core of every American.

As one delves deeper into the language of the ACA, the sinister design of IPAB begins to emerge from the shadows like the black wraiths on Weathertop surrounding the poor hobbits. The writers of the ACA were not just content to make IPAB a law unto itself. They crafted the language in such a way as to allow for this regulatory board, with all its autonomy and unrestrained power, to have the potential to move from a 15-member panel to one unelected controller and finally even transferring its power over to the Secretary of Health and Human Services.

As stated in our last post, the ACA calls for 15 healthcare and financial professionals to sit on the Independent Payment Advisory Board. The President appoints them. This is where the details of the membership start to take some strange twists.

The term for a board member is two years. At the end of the term, the President may or may not choose to reappoint the member. The President is not required to fill the vacancy.

All that is required for IPAB to pass a ruling is a simple majority of the sitting members. One should pay close attention to the phrase “sitting members”. ACA does not require IPAB to maintain 15 members in order to function; in fact, the language in the ACA allows for IPAB to operate with only one member on the panel. The ACA even goes so far as to say that in the event that there are no members of IPAB capable of performing their duties the power of the panel is transferred to the Secretary of Health and Human Services.

Now couple this with what we learned in our earlier post that if IPAB is not repealed before 2017 it could never be repealed. Not only can it not be repealed but also the edicts and rulings IPAB decrees cannot be altered or challenged from any branch of the government or the people of the citizenry. Marry that with the troubling potential that this inordinate amount of power has the potential to be vested in one unelected individual. IPAB has the power, if not repealed, to rewrite the Constitution through statute, warns the Cato Institute.

But you might argue that these are simply precautionary measures.   Really? When has the government shied away from declaring an emergency or special situation? The markers have been laid and the roadway paved to a destruction of what the framers of the Affordable Care Act called “too much democracy”.

One always knew when reading Tolkien’s classic that the powers the Black Riders wielded was given to them for as long as they served the purpose of their master, which was always to bring all under his control. One has to wonder if the goal of the writers of the ACA was from the beginning to centralize all power under one authority with no avenue of challenge. Have we really gotten to this? “One health to rule them all, One health to find them. One health to bring them all and with our care we bind them.”

Scary, Scary IPAB


Americans knew that when they were told that they needed to pass the healthcare law in order to see what was in the healthcare law, we were in for some deep piles of “youknowwhatssits”. Now that the Affordable Care Act has been passed, we are now learning that the healthcare monstrosity has moved into the “just wait a while and you’ll never be able to repeal it” phase. The Obama administration is hoping you’ll just “wait a while” until 2017 and here’s why.

Language within the Affordable Care Act (ACA) created a fifteen member regulatory panel called the Independent Payment Advisory Board (IPAB). The President of the United States appoints these members. This regulatory board has been given unprecedented autonomy in its legislative power in that the proposals issued from IPAB must be implemented immediately. If the President and the two chambers of Congress cannot come up with a measure that matches, not revokes or countermands, but matches the “proposal” of IPAB within a severely limited amount of time the edicts-Let’s call them what they are-from IPAB must be immediately implemented by the Secretary of Health and Human Services, according to the language in the ACA.

IPAB effectively bypasses any oversight from Congress and cannot be subjected to a veto from the President. There are no checks and balances; in fact, language in the ACA prevents IPAB from ever being repealed after 2017. The ACA goes even further to state that any ruling from the IPAB after 2017 cannot be altered, challenged, or revoked in any way.

So after you’ve wiped the spittle from off the front of your shirt from screaming and frothing, “How can this happen in the United States!!!” let’s take a step back and discuss how this happened in the United States. The simplest explanation is that the intent from the very infancy of the ACA was to bypass and circumvent the checks and balances our government. Peter Orszag, who was a chief architect for President Obama when ACA was passed, said the reason for the failed implementation of government run healthcare is that there is “too much democracy”. Orszag and the President petitioned the writers of the ACA to create IPAB and insure that it was impervious to the obstructions of government oversight. By severing the panel from a system of checks and balances and filling it with unelected members with no accountability to the public, the ACA has insured that IPAB is a law unto itself.

This secretive but all-powerful order of health regulators invokes images of Tolkien’s Ringwraiths, The Black Riders, bent upon the implementation of their dark agenda at all costs and woe to any that oppose them. In a recent article from the Cato Institute, Diane Cohen and Michael F. Cannon contend that IPAB is indeed independent but “in the worst sense of the word. It wields power independent of Congress, independent of the President, independent of the judiciary, and independent of the will of the people.”

The citizens have no recourse against the rulings of IPAB. They cannot challenge any ruling in a court of law. IPAB has the autonomous power to levy taxes and ration healthcare for US citizens, even if these citizens have private healthcare. In truth, actions from IPAB are not legislative but decrees and edicts, which cannot be questioned.

Our next post will expose how that, without repeal, IPAB has the potential to give one unelected official the unfettered power to levy taxes and regulations, appropriate funds, and to have control over the legislative process. Thankfully Maine’s Congressman Bruce Poliquin has co-sponsored a bill with Congressman David (Phil) Roe of Tennessee to repeal the Independent Payment Advisory Board. Maine’s Congresswoman Chellie Pingree must join with Congressman Poliquin to repeal this travesty to American freedom. As Cohen and Cannon have warned, IPAB is not just unconstitutional; it is “anti-constitutional.”

Bill to Repeal IPAB to be Announced

Sources in Washington D.C. have informed TMCV that Congressman Bruce Poliquin intends to announce the end of this week, possibly Thursday morning, that he is an original co-sponsor of a bill HR 1190 which repeals the Independent Payment Advisory Board (IPAB) established by the Affordable Care Act.  IPAB has been labeled by the Cato Institute as perhaps the most unconstitutional part of the ACA, and may be the most unconstitutional creation in the history of the United States.  It has also been denounced by the AAMC, the Association of American Medical Colleges.

IPAB is a regulatory board created through the Affordable Care Act, at the behest of President OBama and his Chief architect at the time Peter Orszag to bypass the checks and balances our government.  The board is composed of 15 healthcare professionals appointed by the President.  The regulatory “proposals” that are issued from IPAB are to be implemented immediately by the Secretary of Health and Human Services without approval from Congress.  If all three branches of government cannot come up with a bill that matches the precise intent of the IPAB “proposal” it becomes law, with no vote from Congress and the President  has no power of veto.

But the appalling autonomy of IPAB does not stop there!  If Congress fails to repeal IPAB before 2017, language in ACA prevents all three branches from repealing this board and/or altering any of its proposals at any time.  This gives IPAB the power to alter the Constitution through statute, or its “proposals”.  Not only does IPAB hold regulatory control over ObamaCare but it also has been granted oversight in the private healthcare market.

This is a brief overview of the egregious attack on the Constitution this facet of the ACA represents. TMCV intends to post several articles on IPAB in anticipation of the announcement of Poliquin that he has joined forces with Rep. David Roe (R-TN) to repeal IPAB.  Diane Cohen, lead counsel challenging the constitutionality of IPAB, and Michael F. Cannon, director of health policies for the Cato Institute, aptly describe IPAB as not just unconstitutional, but “anti-constitutional”.

IPAB must be repealed and abolished.  We applaud Rep. Poliquin (R-ME) and Rep. David Roe (R-TN) for their leadership on this.