Austin Frakt with a post following up Ezra Klein's comments on similarities between the Affordable Care Act (ACA) and Paul Ryan's Roadmap in terms of addressing cost inflation in Medicare. Part of Klein's point was to ask why Ryan thinks Congresses of the future would do his preferred hard things, when he has been saying Congress will not do hard things to implement the ACA. I have also written about this.
Austin today notes that Ryan's Roadmap health policy plans empowers the Sec of HHS to enforce future Medicare growth rates, while Austin thinks an IPAB has a better chance of doing a better job and wonders why Ryan would prefer one political appointee for this important task as compared to a broad based board such as IPAB doing it. The answer I think is that an independent board such as the IPAB is a classic example of an idea that once had bipartisan policy support, but which become politically partisan once it appeared in the ACA.
On May 20, 2009, Rep. Ryan (along with co-sponors Nunes in the House and Coburn and Burr in the Senate) introduced the Patients' Choice Act. It contained two boards that would apply cost effectiveness research and the like in an effort to improve quality and reduce spending (Title VIII of the PCA). Thus, Rep. Ryan proposed a more robust version of the IPAB, about a month before the first House Committee reported out HR 3200.
This is just one of many examples of Republicans vehemently opposing ideas in the ACA that they once supported, and in this case, even proposed.