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“The PPACA repeatedly refers to any IPAB proposal as a ‘legislative proposal’ and speaks of ‘the legislation introduced’ by the IPAB. Each proposal automatically becomes law unless Congress passes — with a three-fifths supermajority required in the Senate — a measure cutting medical spending as much as the IPAB proposal would.
This is a travesty of constitutional lawmaking: An executive branch agency makes laws unless Congress enacts legislation to achieve the executive agency’s aim.”

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