As it has in previous years, the president’s 2016 budget proposal relies on savings achieved by strengthening the Independent Payment Advisory Board–this time to the tune of more than $20 billion. Created as part of Obamacare, IPAB was intended to be a group of non-partisan experts, nominated by the president and confirmed by the Senate, who would make recommendations on slowing the growth of Medicare costs. The recommendations were to take effect automatically unless overruled by Congress.

Although the health-care law was enacted nearly five years ago, the administration has made no attempt to constitute IPAB:

* The president has not nominated members to the board for Senate confirmation;

* The president has signed appropriations legislation rescinding spending reserved for the board, most recently in Section 522 of last year’s “cromnibus” legislation;

* While secretary of health and human services, Kathleen Sebelius testified before Congress in 2011 that her agency would undertake a rule-making process to define “rationing.” Obamacare prohibits IPAB from rationing, but the term is not defined in statute. The administration, however, has not begun such a regulatory process.

When questioned on this issue, the administration has argued that the slowdown in Medicare spending makes the board unnecessary at the moment. Administration officials could also make the accurate—if politically unpopular—assertion that the Department of Health and Human Services has the power to implement Medicare savings proposals unilaterally in the absence of a fully functioning board.

Nevertheless, the administration continues to rely on budgetary savings presumed to come from “strengthen[ing]” a board that President Obama has not moved to establish. That raises questions about its commitment to budgetary savings—and to IPAB itself.

This post was originally published at the Wall Street Journal Think Tank blog.