I have been concerned that the Medicare Independent Payment Advisory Board posed a potential risk to Medicare. Recommendations from the board to cut costs would be very difficult for Congress to override, requiring a 60 percent vote, giving excessive power to unelected officials. I would hate to see a Republican president and Congress pack the board with conservatives who would recommend changes to reduce costs which would be harmful to the program. In the long run this remains a concern, but short term we might not have to worry about Republicans on the Board. The president selects three member and the leaders of each party from each chamber of Congress also nominate three members. In a letter to President Obama, John Boehner and Mitch McConnell said that they would not make any appointments to the Independent Payment Advisory Board.
The IPPB can still function without the full fifteen members and any decisions in which the Republicans don’t take part might be preferable. As all fifteen members must be confirmed by the Senate, it will be interesting to see if the Republicans filibuster all appointments. They certainly have demonstrated a willingness to block Obama’s appointments just for the sake of blocking them. If the IPPB fails to make recommendations, the Secretary of Health and Human Services could make the recommendations instead. The end result of Boehner and McConnell’s actions would then be to give more power to the Obama administration initially.