The Independent Payment Advisory Board, or IPAB, is one of the more notorious provisions of the Affordable Care Act because it is the perfect embodiment of belief in technocratic expertise. The IPAB’s 15 “expert” members would have great power and little accountability.

Since the law’s passage in 2010, opponents have successfully publicized the danger the IPAB poses to sensible Medicare policy and constitutional self-government, to the point that many in Congress now assume it will never go into effect. In June 2015, the House passed legislation to repeal the IPAB in its entirety.

And, yet, it is also clear that Congress’ attention is elsewhere. The slowdown in Medicare spending growth in recent years has made the IPAB less relevant – for now.

But IPAB’s demise is not a foregone conclusion, especially when Medicare spending growth accelerates again, as it almost inevitably will.