Originally
posted by
Eric171:
Originally
posted by
trumper:
As for the ACA, aka Obamacare, the law is a mixed bag of items. Those downplaying the significance of the individual mandate probably aren't students of history to recognize the significance of such an action.
I tend to be of the belief that portions of the ACA can and will be shot down in court. For instance, portions of the law attempt to bind the hands of future Congresses such as IPAB. By and large, the courts have held that one Congress can't fully limit the power of a future Congress except through the amendment process. In the case of IPAB, by force of law, it meets the same threshhold of a Constitutional Amendment unless a fast-tracked Congressional process finds equal cuts within the same legal parameters (can't cut benefits, can't ration care, can't raise the eligibility age, can't touch hospitals or hospice care until 2020, etc). It's just bad policy.
no matter what is written, how can it bind a future Congress? They only need to pass a new law, and new laws overrule old ones...
Well, that's sort of the subject of the debate. The court hasn't really definitively ruled on the subject.
In this case, the IPAB law basically says it comes into being on 1/1/14 and any attempt to stop the process requires a 3/5ths vote in both chambers of Congress presuming that the President does not veto the legislation.
Morever, it says IPAB must make recommendations (they're actually really force of law) if the target threshhold was met (for interpretive purposes, the threshhold would have been met in 20 of last 24 years). These recommendations cannot raise the eligibility age, change benefits to Medicare recipients, or 'ration care' (no definition of the latter provided). Once these recommendations are offered to Congress by a specified date then the committees of jursidiction then the committes have 2.5 months to come up with a competiting plan that follows the IPAB rules or they forfeit their right to stop IPAB (unless of course they have 3/5ths votes to stop the process) and IPAB's decision becomes law by default. If IPAB is required to offer recommendations and fails to offer them or the President fails to appoint members, then the Secretary of HHS must offer the recommendations. The decision of IPAB may not be judicially reviewed.
In other words, a future Conrgess can't stop IPAB without dismantling the process 3/5ths majority in both chambers and Presidential support or by following a series of parameters set out in the current law (fast-tracked timeline, same or more cuts w/o touching age, benefits, etc). If that's not binding the hands of future Congresses than I don't know what is.
The biggest plans to address Medicare spending today are really converting the program from defined benefit to defined contribution, aka switching to a premium support model. They also include provisions to increase eligibility age. These aren't even permissible options for the rebutall offering to IPAB post-2014.
So we're back to your question, is this even permissible? And then we have to wonder what the courts say even though they're technically forbidden by this very law from reviewing that question. It's a legal conundrum.