Defunding the IPAB is Not Enough to Keep HHS from Rationing (Updated)

The Hill’s Floor Action Blog, yesterday, reported that Republicans plan to defund the Independent Payment Advisory Board(IPAB)(formerly called the "Independent Medicare Advisory Board") calling it a “rationing entity.”

While this is welcomed news, defunding the IPAB is not enough to stop the implementation of rationing power.

Here’s why: If the IPAB does not submit a proposal to Congress by its January 15 deadline, the Secretary of the Department of Health and Human Services (HHS) is required to submit a proposal in its place to the President by January 25. The President then has two days to send the proposal to Congress. A proposal drafted by the Secretary will have the same effect as a proposal drafted by the IPAB.

In other words, the power of a defunded IPAB will be transferred to the Secretary of HHS.

Thus, besides defunding the IPAB, Congress must also prohibit HHS from using funds to act in place of the IPAB.

Update (4/11/2011): H.AMDT.170 to H.R.1, proposed by Rep. Nan Hayworth (R-NY), contains language which, if it found its way into law, would be sufficient to defund both the IPAB and anyone else assuming its powers in its absence (i.e. the President and the Secretary of HHS).

Here's how the amendment reads:

OFFERED BY: MS. HAYWORTH AMENDMENT NO. 567: At the end of the bill (before the short title), insert the following: SEC. ll. None of the funds made available by this Act may be used to implement section 1899A of the Social Security Act (42 U.S.C. 1395kkk), as added by section 3403 of the Patient Protection and Affordable Care Act (Public Law 111–148).
H.R. 1

You will notice that this amendment defunds implementation of the applicable section of the U.S. Code. So, anyone claiming power under this section whether it be the IPAB itself or the President and Secretary of HHS claiming power in the IPAB's absence would be prevented from implementing the provisions of this section due to lack of funding.