A repeal of the Independent Payment Advisory Board takes one step closer to reality

The Independent Payment Advisory Board may finally be coming to an end.

The House Ways and Means Committee has approved a bipartisan bill to repeal the IPAB to prevent the unelected advisory committee from slashing Medicare. The committee voted 24-13 last week in favor of the legislation (PDF) to eliminate the 15-member board, established under the Affordable Care Act to convene if Medicare spending exceeds a particular limit. The board’s purpose would be to make recommendations to cut Medicare to reduce the spending growth.

Although the IPAB has been unpopular since its inception, the latest Medicare Trustees report said that there will be no need for an IPAB panel until 2021. So far neither President Obama nor President Trump has appointed anyone to the board. Therefore, if the mechanism is triggered prior to the appointments, the law gives authority to the sitting secretary of Health and Human Services to make the required cuts.

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But if the IPAB is not repealed, the only way to avoid the panel’s recommendations would be for Congress to decide on the cuts and agree to them via a two-thirds majority vote.

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Representatives Phil Roe, M.D., R-Tenn., and Raul Ruiz, M.D., D-Calif., sponsored the legislation, which they believe would prevent the panel from making cuts that could compromise seniors’ access to healthcare. “Putting Medicare on sustainable financial footing is a top priority for this Committee, but passing the buck to a handful of unaccountable bureaucrats is not the right approach,” said Ways and Means Committee Chairman Kevin Brady, R-Texas, at the markup, vowing to bring the legislation to the House floor.

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But the Washington Examiner reports that Democrats indicated during the markup that the committee needs to work on other priorities, such as disaster relief for Puerto Rico and reauthorizing and extending healthcare programs like the Children’s Health Insurance Program, because Congress could overrule IPAB recommendations. "I am disappointed we are here today to mark up one of the least timely agenda items on our to-do list," said Rep. Bill Pascrell, D-N.J., according to the newspaper.