Political Animal


May 10, 2013 10:59 AM Coming Soon: the Death Panel Filibuster

By Ed Kilgore

By loudly refusing to make nominations (as they are entitled to do under the terms of the Affordable Care Act) to the Independent Payment Advisory Board charged with identifying Medicare cost savings, Speaker John Boehner and Senate Minority Leader Mitch McConnell are signaling a new and toxic phase in the war on health care reform. TPM’s Sahil Kapur has the essential background:

The top two Republicans in Congress informed President Obama on Thursday that they will refuse to fulfill their duty under the Affordable Care Act to recommend members of a new board with the power to contain Medicare spending.
It’s a dramatic power-play driven by the explosive partisan politics of Obamacare and with potentially important implications for federal health care policy.
In a letter to President Obama, House Speaker John Boehner (R-OH) and Senate Minority Leader Mitch McConnell (R-KY) noted their original opposition to Obamacare, reiterated their intent to repeal it entirely, and declared that they would not make any appointments to the Independent Payment Advisory Board.
The IPAB is a 15-member panel whose members must be confirmed by the Senate. The President selects three members himself and is required by law to seek three recommendations each from the top Democrat and Republican in each chamber. With Thursday’s letter, Boehner and McConnell refused to make any recommendations.
The IPAB will be stood up in 2014 by Obamacare and tasked with making cuts to Medicare provider payments (it may not touch benefits) if costs exceed economic growth plus an additional percentage point in any given year. Congress can override it by passing equally large cuts with a simple majority or waiving the cuts entirely with a three-fifths majority.
“Because the law will give IPAB’s 15 unelected, unaccountable individuals the ability to deny seniors access to innovative care, we respectfully decline to recommend appointments,” Boehner and McConnell wrote in the letter.

Keep in mind that IPAB is essentially a beefed-up version of the MedPAC panel created in the 1997 Balanced Budget Act at the urging of congressional Republicans. While MedPAC made recommendations that were routinely ignored by Congress, any cost-savings measures recommended by IPAB take law unless they are vetoed by Congress.

But forget the details: IPAB is the “death panel” famously denounced by Sarah Palin in her massively influential shout-out to the antichoice movement and its eternal claims that secular socialists want to follow up legalized infanticide with wholescale euthanasia against the disabled and elderly. IPAB is also, of course, a convenient target for the immensely hypocritical but nonetheless powerfully repeated Republican attack on “Obama’s Medicare cuts,” in turn a not-so-subtle effort to convince comfortable white seniors that Democrats want to take away their hard-earned government health care benefits and give them to those people, the riffraff on “welfare.”

In other words, IPAB is at the beating heart of the entire attack on Obamacare. So not only will congressional Republicans resist cooperation in its creation: they are certain to launch filibusters in the Senate against any actual presidential nominations.

The irony is that in the absence of IPAB the administration is empowered to issue its own Medicare cost-savings recommendations. But ultimately, this isn’t about health reform policy, or for that matter, about Medicare or even ACA. It’s a full-on Republican attack on the president using, in tandem, every major weapon in the arsenal: lies, hypocrisy, and of course, the filibuster. It could prove to be an epic rumble.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.


  • c u n d gulag on May 10, 2013 11:05 AM:

    The Republican Party is now a Nihilistic cancer, eating at the very heart of democracy.

    Too bad so many of our voters are too stupid and/or ignorant to realilize it.

    I'd leave this soon-to-be banana republican sh*thole, but, unfortunately for me, I'm too old, so I'll go down with the ship.

  • mk3872 on May 10, 2013 11:11 AM:

    I'm sure that this is just a simple problem of "Presidential Leadership", (c) 2013 by MoDo & Millbank.

    With just a little arm-twisting and beers with the GOP, they'll start supporting Obamacare, am I right?

  • Neildsmith on May 10, 2013 11:15 AM:

    One of these days, progressives will realize they have no agenda left. The American people have empowered the GOP to maintain the status quo. Personally, I think it is time to start punishing the groups that vote for the GOP or don't vote at all. What is the point of protecting the fox news geezers from SS and Medicare cuts?

  • jmax on May 10, 2013 11:45 AM:

    Is there someone who can sue the Republican leadership for dereliction of duty? Who would have standing?

  • Peter C on May 10, 2013 11:50 AM:

    If they won't make suggestions, I think Obama should consider recess-appointing Van Jones, Barbara Ehrenreich and Michael Moore.

  • Ronald on May 10, 2013 11:59 AM:

    Time to call it what it is:
    a god-damn temper tantrum.

    F**K I am tired of the Republicans right now.

  • Peter C on May 10, 2013 12:11 PM:

    Then again, it would seem to me that 9 members of a 15-member-board would constitute a quorum. It sounds like they could be surprisingly productive and effective with a few regrettable vacancies.

  • gdb on May 10, 2013 12:38 PM:

    "Itís a full-on Republican attack on the president using, in tandem, every major weapon in the arsenal: lies, hypocrisy, and of course, the filibuster. It could prove to be an epic rumble."

    And this is a new insight?? Some of us Progressives have been saying this for 5 years. And the respose by BHO and most Dems in power have been the 21st century version of Neville Chamberlain or James Buchanan to intractable opposition. What is needed is a Progressive Churchill to strongly and consistently advocate Keynesian economic policies-- and that ain't gonna be someone named Barack or Hillary. Until that happens, we will continuously drift rightward... aided and abetted by the Obamas, Clintons, and Reids in leadership positions.

  • jim filyaw on May 10, 2013 12:54 PM:

    in the words of the biggest dipsh*t to ever hold the office of president, "bring it on!". its about time we found out whether reid and the supposed democrat majority in the senate have the cajones to do their job!

  • gratuitous on May 10, 2013 1:35 PM:

    So, the Republican leadership is refusing to carry out the law of the land, certified constitutional by the Supreme Court, is that right?

    How tough is it to make this case in the popular media? I think even the slowest coaches can grasp the concept. Or is that too "Green Lantern" or "bully pulpit" and therefore unworkable for our Democratic leaders?

  • bdop4 on May 10, 2013 1:35 PM:

    Peter C - great point.

    Just keep moving forward and implement good policy. After a year or two, even the GOP morons will have to admit the sky isn't falling. And if they don't, their credibility will be eroded even further.

  • KC on May 10, 2013 4:25 PM:

    I vote for what Peter C says too. However, expecting Obama to actually show up to a fight without giving up his gloves to begin with is like waiting for pigs to fly--big waste of time.

  • boatboy-srq on May 10, 2013 4:44 PM:

    Shorter GOTea: saving federal funds is wonderful - unless it a) helps the IslamoFascoSoshulist Usurper; b) reduces federal largesse to our campaign financiers; c) actually makes government work; d) any combination of the above.

  • Doug on May 10, 2013 8:01 PM:

    *Both* McConnell and Boehner are refusing to make any nominations, even though the nominees have to be confirmed by the Senate, eh? Sounds to me as if there may be five possible Republican "squishes" that are worrying McConnell.
    Either that or McConnell is worried about the consequences of filibustering all 15 nominations?