The Independent Payment Advisory Board aroused considerable furor when it was included in the 2010 healthcare overhaul, then all but vanished from the public consciousness. It’s about to come roaring back, and Congress should kill it before it can.
The idea behind the IPAB is to restrain the growth in spending by having 15 bureaucrats decide what should and should not be covered by Medicare – in effect, those unelected “experts” will be rationing healthcare for some of our most vulnerable citizens.
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IPAB is supposed to come into being when Medicare spending growth begins to exceed target levels. We’re not there yet.
The report from the Centers for Medicare and Medicaid Services’ chief actuary, who determines whether growth is exceeding projections, is past due for 2017. But projections indicate there is a good chance growth will exceed the target this year or next. That gives Congress a narrow window to kill the beast before it emerges fully from its lair.
The decisions made by IPAB carry the force of law unless Congress specifically rejects them under Obamacare rules that make such a rejection extremely difficult. That gives this cabal of Washington power brokers almost unilateral authority to dictate healthcare policy, putting those bureaucrats between you and your doctor.
Congress has for the second year in a row refused to fund the IPAB as it awaits its summons from the actuary. But starving the beast isn’t good enough. Lawmakers need to drive a stake through its heart.
Even if IPAB is not funded and no board members are appointed, the Affordable Care Act empowers the secretary of Health and Human Services to unilaterally implement program changes — such as altering what drugs or devices are covered, for example — to bring actual costs back into line with projections. This may not sound bad under Secretary Tom Price, but could raise problems under future administrations.
Congress abdicated its responsibility when it handed over that much authority. It can live up to its responsibility and reclaim its authority to write laws by getting rid of the IPAB.
There is bipartisan consensus to do just that.
Sens. John Cornyn, R-Texas, and Ron Wyden, D-Ore., have authored legislation to fully repeal the IPAB. In the House, Reps. Raul Ruiz, D-Calif., and Phil Roe, R-Tenn., are lead sponsors on a repeal measure, which has 124 cosponsors.
Short of an outright repeal, these same lawmakers have also introduced joint resolutions that would discontinue the process for automatic implementation of IPAB recommendations.
In hyper-partisan Washington, this type of bipartisan support is rare. Members of Congress should seize the opportunity to show the American people that they can still work together for the public good and put an end to this disastrous and unaccountable panel.
Repealing Obamacare may be months away, at best, and will be a highly partisan and divisive fight.
But Congress can act right now, in a bipartisan fashion, to get rid of one of the law’s worst aspects. Republicans and Democrats should act together to protect seniors and slay the Independent Payment Advisory Board.
Tyler Q. Houlton is the director of federal affairs at Americans for Prosperity.
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