Obamacare created an Independent Payment Advisory Board (IPAB).
The folks on this board are appointed.
They will set prices and payment for medicine and medical care and decide who gets care. And who doesn’t.
Anything they submit to Congress becomes law and the Secretary of Health and Human Services is required to implement it, using her thousands of beaurocrats and the IRS.
The only way to block what they propose is if both houses of Congress AND the president agree on a substitute.
Otherwise it is the law. No congressional debate. No congressional oversight. No presidential veto. And no bothersome court challenges by us annoying civilians.
The only chance that Congress will have to alter it is during a 7 month window in 2017, and that will require 3/5ths of both houses. After that window, no Congress will be allowed to make any changes.
The IPAB will wield power independent of the Congress, Independent of the president, independent of the Supreme Court, and independent of the people.
We will no longer bother with even the pretext that we are self-governed.
If the Supremes let it stand.