House Moves One Step Closer to Passing Bill to Repeal the Independent Payment Advisory Board
Majority of Lawmakers Vote to Move Bill Forward, Final Passage to Occur Next Week
June 22, 2015 08:05 AM
The House of Representatives this week moved one step closer to passing legislation that would repeal the Independent Payment Advisory Board (IPAB) by approving a procedural motion allowing final passage of the legislation in the coming week. The House held the procedural vote in addition to voting to repeal the medical device tax, both of which were votes the House scheduled earlier in the week, as previously reported.
In order to become law, the IPAB repeal legislation would still need to pass the Senate and be signed by the President. However, the House vote indicates the serious concerns about IPAB and the overwhelming support in Congress for repealing the board moving forward.
“This is an agency that I believe should not exist and does not follow our democratic ideals,” said Congressman Paul Ryan (R-WI) during the debate over the legislation.
In addition to the repeal efforts, the House Appropriations Subcommittee that oversees the Department of Health and Human Services passed a spending measure this week that again defunds IPAB by rescinding the $15 million in annual funding made available for the board under the ACA. Since IPAB was first established, Congress has continually denied its funding due to concerns.
IPAB, as established under the ACA, is a board of presidential appointees with the power to make recommendations to cut Medicare if expenditures reach a certain level. IPAB’s actions would be subject to little oversight with no judicial review once the Secretary of Health and Human Services implements a recommendation.
Proponents of IPAB claim it could result in health care delivery reforms, but there is concern the board would instead focus on short-term cuts because of a requirement under the law that IPAB achieve savings within one year. The National Association for Home Care & Hospice (NAHC) additionally objects to giving an unelected board the authority to put forward Medicare cuts. Instead, NAHC argues, the democratically elected members of Congress should have the authority to debate and make changes to Medicare, which is a public program upon which millions of seniors and disabled persons rely. IPAB limits the power of citizens to petition Congress and meaningfully participate in the lawmaking process.
The Congressional Budget Office, as previously reported, released a summary estimating that the IPAB repeal legislation would not affect spending between 2015 and 2021, but that it would increase direct spending by $7.1 billion over the 2022-2025 period. As a result, the legislation uses a portion of the Prevention and Public Health Fund (PPHF) from FY2017-FY2025 to offset its cost. Due to concerns about this specific offset, NAHC supports efforts to identify an alternative offset before the bill becomes law.
NAHC Report will continue to provide updates regarding the status of this legislation.