“Mr. Obama wants to expand the power of the 15-member 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.”

“Messrs. Ryan and Obama agree that Medicare spending must decline, and significantly. The difference is that Mr. Ryan would let seniors decide which private Medicare-financed insurance policies to buy based on their own needs, while Mr. Obama wants Americans to accept the commands of 15 political appointees who will never stand for election.”

“The ACA presents New York policymakers with a unique opportunity to reform its individual and small-group insurance markets. However, creating an effective market-based exchange requires policymakers to recognize that simply imposing its current high-cost insurance arrangements on the exchange may lead to the collapse of the exchange over time. Instead, reforms should build on the lessons learned from state exchanges in Utah and Massachusetts, federal programs such as Medicare Part D, and private exchanges such as New York’s HealthPass.”