House of Representatives Votes to Eliminate Medicare Cost-Saving Body
By a largely party-line vote of 223-181, the House of Representatives last week approved legislation that would strip the Obama Administration’s health care law of a provision that creates a cost-cutting board known as the Independent Payment Advisory Board (IPAB).
The IPAB was included in the Patient Protection and Affordable Care Act (ACA)
in an effort to limit the per-capita growth rate of Medicare spending. Previously, Congressional authorization had been required to change reimbursement rates for Medicare, the public health insurance program for Americans who are over 65 or disabled. The creation of the Board would allow for administrative changes to be made without Congressional approval.
The ACA dictates that if the Centers for Medicare and Medicaid Services
anticipate increases in Medicare spending that will exceed annual targets, IPAB must propose corresponding spending reductions. IPAB’s proposals, or alternative fallbacks devised by the Secretary of Health and Human Services
, are to be implemented unless Congress succeeds in enacting resolutions that override them. If established, the Board could submit its first proposal as early as January 2014
Critics, including employers and health care organizations, are concerned that the IPAB will undermine Medicare by giving an independent, undemocratic body primary control over key health care decisions. They argue that repeal the authority given to the Board will “restore the doctor-patient relationship in Medicare”
and keep the costs of private health care in check
. Conversely, proponents of the IPAB argue that it is necessary to keep Medicare spending within reasonable limits and protect the program’s solvency
The corresponding bill, S.218, would need to be passed by the Democratically-controlled Senate to become law, which does not appear likely.