Mr. Orszag, you may recall, was the administration’s main proponent of “bending the curve” on health care expenditures. Frustrated that House Democrats wouldn’t accept some painful cost-cutting measures in the new health care law, Mr. Orszag pushed for and won a controversial provision to create something called the Independent Payment Advisory Board. This is an outside commission of 15 appointees who will, beginning in 2014, identify cuts to Medicare if the plan exceeds a preset rate for growth. Congress then has to either approve the cuts or propose an alternative.-Budget Chief tried to tilt power to Executive Branch
The significance of this new advisory board goes well beyond the immediate question of how to rein in Medicare costs. Mr. Orszag, who declined to be interviewed, has said that the board represented, for Congress, the “single-biggest yielding of power to an independent entity since the creation of the Federal Reserve.” In other words, the Medicare Board isn’t only a means of cutting government spending; it is a means, too, of wresting the constitutional responsibility for budgeting away from powerful committee chairmen.
The Medicare Board may be the most striking example of this strategy, but it is hardly the only one. Mr. Orszag also helped broker the creation of an 18-member debt commission that will offer specific alternatives for re-ordering the federal budget. The administration has also proposed a bill — known in the punchy language of Washington as “expedited rescission authority” — that would effectively give the president the power to strike out spending items after the budget has been approved.