More Obamacare Rationing Evidence: Exchange Plans Limit Access Not Only to Top Hospitals and Doctors, But Also to Drugs

By Jennifer Popik, JD, Robert Powell Center for Medical Ethics As mainstream media outlets are reporting, and as NRL News Today has repeatedly documented, tens of thousands who had individual health insurance policies that were terminated against their will...MORE

As Americans Lose Both Their Insurance and Their Doctors, The Rationing Built into Obamacare is Being More Widely Acknowledged

By Burke Balch, JD, Director, Robert Powell Center for Medical Ethics As the mainstream media is now commonly reporting, and as NRL News Today has repeatedly documented, individuals whose health insurance policies are being terminated against their will are.....MORE

Obama Falsely Claims that Forced Cancellations Will Mean Better Plans in the Exchanges

By Jennifer Popik, JD, Robert Powell Center for Medical Ethics Public frustration and anger over Obamacare is mounting. Despite numerous and repeated assurances from President Obama that if you liked your insurance plan you could keep it, millions of Americans...MORE

Massachusetts Rationing Shows What’s Coming to All America Under Obamacare

By Burke J. Balch, J.D., director of NRLC’s Powell Center for Medical Ethics President Obama is holding up the Massachusetts health care law as a good precedent for what Obamacare will bring when fully implemented. It’s a good precedent, all ...MORE

Exchange enrollees finding insurance plans that limit specialists and hospitals

By Jennifer Popik, JD, Robert Powell Center for Medical Ethics As Americans engage in the increasingly frustrating process of attempting to enroll in health plans in new health care exchanges, many are finding their alternatives limited to cut-rate plans that allow...MORE

Will Obama Make Recess Appointments to Controversial IPAB?

Over the past several weeks, the White House has been scrambling to gain support for one of the most contentious and central provisions of the Obama Health Care Law, the Independent Payment Advisory Board (IPAB). Now it appears the Administration could ensure the Board’s operation even if the Senate refused or appeared unlikely to confirm those whom President Obama will appoint as its members by making what are called “recess appointments.” In light of a mounting bi-partisan call in the House to repeal the IPAB, this attempt virtually guarantees an immense fight.

Although many news accounts have focused on the Board’s mandate to impose Medicare cuts that a Congressional majority may not reduce, less attention has been given to the IPAB’s role in reducing what all Americans will be permitted to use out of their own private funds for their family’s health care. The Obama law directs the IPAB to issue recommendations to limit what ordinary citizens and their health insurance coverage can pay for medical treatment so as to prevent it from keeping up with the rate of medical inflation.

To implement these recommendations, the federal Department of Health and Human Services is empowered to impose so-called “quality” and “efficiency” measures on health care providers. Doctors who violate a “quality” standard by prescribing more lifesaving medical treatment than it permits will be disqualified from contracting with any of the health insurance plans that individual Americans, under the Obama Health Care Law, will be mandated to purchase. Few doctors would be able to remain in practice if subjected to that penalty.

This means that treatment that a doctor and patient deem advisable to save that patient’s life or preserve or improve the patient’s health, but which exceeds the standard imposed by the government, will be denied even if the patient is willing and able to pay for it.

A bill before Congress for IPAB’s repeal has 144 co-sponsors from both sides of the aisle. The Hill newspaper reports that over 270 medical organizations sent a letter to Congress urging repeal late last week.

However, even if passed by the House, it is nearly certain that repeal this year or next would stall in the Senate, or face an Obama veto.

Now public attention is being drawn to the President’s potential ability to get the Board up and running even in the face of Senate opposition to his appointments to the Board.

Responding to an inquiry from pro-life Senator Tom Coburn (R-OK), the non-partisan Congressional Research Service concluded that President Obama could make enough recess appointments, including a chair, to conduct business. While the law does not require the Board to begin issuing reports until 2014, it provides funding for its operations starting October 1 of this year when federal Fiscal Year 2012 begins.

Both President Obama and Kathleen Sebelius, his Secretary of Health and Human Services, have been insistent in defending the Board. In an April 13 deficit speech, the President advocated directing the Board to limit even further which of their resources private citizens will be permitted to devote to saving their lives and those of their family members. In a recent op-ed piece, Sebelius lashed back at its critics, making the self-contradictory claim that it will be both “independent” and “accountable to Congress and the president.”

To prevent an end-run, the House of Representatives could use its constitutional power to prevent the Senate from adjourning for more than three days without its consent to attempt to prevent the occurrence of a “recess” that would enable Presidential recess appointments. Those concerned about the dangerous rationing in which the IPAB recommendations would play so critical a role would be well advised to urge their Representatives to ensure that the House does so.

More details on the rationing in the Obama Health Care Law are available here.

Even Critics of ObamaCare’s Independent Payment Advisory Board Miss Its Worst Rationing

Recently there has been a fair amount of press coverage of the effort to repeal a central aspect of the Obama Health Care Law—the unelected 18-member Independent Payment Advisory Board given sweeping powers to limit what people are allowed to spend for health care. Strangely, however, most critics focus only on its impact on Medicare spending, and at least one of its defenders appears ignorant of the authority it will exercise to limit Americans’ use of their own private funds.

Democratic representatives are increasingly joining Republicans in co-sponsoring H.R. 452, a bill to repeal the Independent Payment Advisory Board. As noted in an April 19 New York Times article by Robert Pear,

Democrats and Republicans are joining to oppose one of the most important features of President Obama’s new deficit reduction plan, a powerful independent board that could make sweeping cuts in the growth of Medicare spending. Mr. Obama wants to expand the power of the 15-member [sic] panel, which was created by the new health care law, to rein in Medicare costs. But not only do Republicans and some Democrats oppose increasing the power of the board, they also want to eliminate it altogether. Opponents fear that the panel, known as the Independent Payment Advisory Board, would usurp Congressional spending power over one of the government’s most important and expensive social programs. Under the law, spending cuts recommended by the presidentially appointed panel would take effect automatically unless Congress voted to block or change them. In general, federal courts could not review actions to carry out the board’s recommendations.

In an April 21 piece defending the board, Paul Krugman, one of the paper’s op-ed columnists, wrote, “Before you start yelling about ‘rationing’ and ‘death panels,’ bear in mind that we’re not talking about limits on what health care you’re allowed to buy with your own (or your insurance company’s) money. We’re talking only about what will be paid for with taxpayers’ money.”

Yet Krugman’s statement is flatly wrong.

As documented with specific quotes from the legislation at http://bit.ly/itblQZ, the Obama Health Care Law specifically directs the board to make “recommendations to slow the growth in national health expenditures” for private—not just governmentally funded—dollars devoted to health care. These recommendations are supposed to limit what ordinary citizens and their health insurance coverage can pay for medical treatment to force it below the rate of medical inflation.

To implement these recommendations, the federal Department of Health and Human Services is empowered to impose so-called “quality” and “efficiency” measures on health care providers. Doctors who violate a “quality” standard by prescribing more lifesaving medical treatment than it permits will be disqualified from contracting with any of the health insurance plans that individual Americans, under the Obama Health Care Law, will be mandated to purchase. Few doctors would be able to remain in practice if subjected to that penalty.

This means that treatment that a doctor and patient deem advisable to save that patient’s life or preserve or improve the patient’s health, but which exceeds the standard imposed by the government, will be denied even if the patient is willing and able to pay for it.

“It is truly astounding that this extreme form of rationing has gone almost unremarked even by critics of the Independent Payment Advisory Board,” said National Right to Life Executive Director David N. O’Steen, Ph.D. “That means it is up to grassroots pro-lifers to make both their elected representatives and media outlets aware of the facts, and of how important it is that the Independent Payment Advisory Board be repealed.”

More details on the rationing in the Obama Health Care Law are available at http://bit.ly/161yrt.