With a mandate to drive down Medicare spending, the Independent Payment Advisory Board has always been among the health law's most-controversial provisions. Legislators in both parties have attacked the board's power to dictate Medicare spending cuts without Congress' seal of approval. While IPAB is specifically barred from changing Medicare's benefits or increasing cost-sharing, critics worry that cutting doctors' payment rates could lead to worse care. For now, IPAB doomsayers can rest assured: The cost-cutting board has been effectively neutered for 2015, the first year in which it's spending recommendations could go into effect. It has lost its power to make any of these binding cuts.