House approves bill to eliminate the Independent Payment Advisory Board

An unpopular provision under the Affordable Care Act that would allow an independent board to cut Medicare if spending rises above a certain limit may end before the panel is ever established.

The House of Representatives on Thursday voted 307-111 in favor of eliminating the Independent Payment Advisory Board (IPAB). The bipartisan bill, sponsored by Representatives Phil Roe, M.D., R-Tenn., and Raul Ruiz, M.D., D-Calif., now moves to the Senate, although The Hill noted it’s unclear whether the upper chamber will vote on it before the end of the year.

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The latest Medicare Trustees report said there is no need for an IPAB panel until 2021 and neither President Obama nor President Trump has appointed anyone to the board. Critics of the advisory board nevertheless say the provision for the panel is a threat because it means if it is triggered, Congress wouldn't have a say on Medicare policy cuts

The House vote was  praised by The Healthcare Leadership Council (HLC), a coalition of 700 healthcare groups that has long urged repeal of the IPAB. The vote, said HLC President Mary R. Grealy in a statement, shows “support of responsible, patient-centered Medicare reform.”

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If the Senate fails to follow suit, she said that the IPAB could mandate arbitrary spending cuts that would make it more difficult for Medicare beneficiaries to see a doctor, get diagnostic tests and receive treatments.

“There simply isn’t a good argument for IPAB,” she said. “Even if you reduce spending in the short run, making patients sicker through reduced healthcare access will only increase hospitalization and emergency room costs in the long term. IPAB is an ill-conceived idea and Congress has the opportunity to rectify it before it does real harm.”

The Goldwater Institute, a conservative research and educational think tank, also supports IPAB repeal but doesn’t hold out much hope that the Senate will vote to end the panel based on previous unsuccessful efforts to do so.

Naomi Lopez Bauman, director of healthcare policy, and Christina Sandefur, executive vice president at the institute, described IPAB as “one of the greatest and most disturbing power grabs in American history."

The 15-member board, they wrote in a blog post, is “unelected and unaccountable to the President, Congress, the courts, or the American people.”

The California Life Science Association, the public policy and business leadership trade association representing California’s life sciences industry, said in a statement that it also applauded the House for voting in favor of eliminating the IPAB. Failure to repeal the IPAB could “harm biomedical innovation by reducing incentives for investment in new research and product development,” it said.