House Passes Bill to Repeal Independent Payment Advisory Board
June 25, 2015 08:40 AM
The U.S. House of Representatives yesterday passed a bill to repeal the Independent Payment Advisory Board (IPAB) established under the Affordable Care Act (ACA). The measure passed by a vote of 244 to 154, with 11 Democrats voting in support.
The National Association for Home Care & Hospice (NAHC) has long urged Congress to pass legislation repealing IPAB based on deep concerns about transferring authority from Congress to an unelected board that has the potential to make short-term, harmful cuts to Medicare.
“The House took an important step this week by passing legislation to repeal IPAB,” said NAHC President Val J. Halamandaris. “Medicare is a public program and should be governed by a publicly-elected body, not an appointed commission. This board currently has the authority to take an axe to Medicare and meddle in payment system reforms, thereby hurting patients across the country. It’s wrong for patients, providers, and strengthening Medicare for the long-term.”
While the House passed the bill, the Senate has not yet approved the legislation. An additional obstacle to the bill becoming law is the fact that President Obama issued a veto threat against the legislation in a statement of administration policy released last week. However, House passage is significant because it indicates important Congressional support for repealing the board.
As previously reported, the legislation included a controversial offset using $7.1 billion in funds from the Public Health and Prevention Fund under the ACA. The Congressional Budget Office had estimated that the bill would increase spending by $7.1 billion over the 2022-2025 period. The bill received some Democratic support despite the contentious offset. NAHC supports efforts to identify an alternative offset before the bill becomes law based on concerns about this specific provision.
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. The actions by the IPAB would be subject to little oversight and there is no judicial review once the Secretary of Health and Human Services implements an IPAB 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. NAHC has also objected to giving an unelected board the authority to put forward Medicare cuts. Instead, 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.