You know legislation is bad when both Democrats and Republicans are trying to find a way to repeal it. On Tuesday the House Ways and Means Health Subcommittee convened for a hearing to examine how the Independent Payment Advisory Board (IPAB) would affect Medicare, beneficiaries, and physicians. The legislation of interest is Section 3403 and 10320 of the “Patient Protection and Affordable Care Act” (P.L. 111-148). The 15 unelected officials of the board would have the duty to cut Medicare spending if the per capita Medicare spending rate became too high. Congress would be able to keep IPAB from regulating Medicare spending, but only if it could come up with alternative means of creating equivalent savings.
Part of the controversy surrounding IPAB stems from the fact that these presidentially appointed bureaucrats will make decisions that are basically considered law, yet remain unaccountable to patients and physicians. President Obama’s administration likes to tout ideas such as transparency and liability. However, a council with private meetings that has the ability to make critical decisions about Medicare reimbursement with no threat of challenge is far from transparent.
Almost every issue these days has a prevalent political divide, but IPAB is unique because Democrats and Republicans alike are showing concern. Bipartisan talk of repealing IPAB has been in conversation since summer 2011. For example, in the past Congressmen Pete Stark (D) described IPAB as “a mindless rate-cutting machine that sets [Medicare] up for unsustainable cuts that will endanger the health of American’s seniors and people with disabilities.” In Tuesday’s hearing to markup the bill, members from both parties were in support of repealing IPAB, and no one in the hearing chamber spoke to defend the status quo of IPAB during today’s hearing.
During the same hearing, Health Subcommittee Chairman Wally Herger suggested a plan to allow Medicare beneficiaries to decide on coverage they want and need, instead of ceding the work to a handful of unelected and unaccountable board members. The Ways and Means Committee is not the only one contesting the decision to repeal the panel. The House Energy and Commerce Committee also voted recently to repeal IPAB; now the Ways and Means Committee plans to follow suit. Revoking IPAB will protect Medicare reimbursements for services as well as senior and disabled citizen’s access to care.