Striking Back Against the IPAB Power Grab
One of the key criticisms of the Independent Payment Advisory Board (IPAB) is that it encroaches upon congressional powers. The IPAB provisions in the Patient Protection and Affordable Care Act (PPACA) state that the 15-member panel’s Medicare spending cut recommendations must take effect unless Congress approves an alternative that achieves at least the same level of savings. The law also dictates that the IPAB recommendations will be placed on the congressional fast track with limited debate.
Today, Congress, or at least the House of Representatives, decided to reclaim its traditional prerogatives.
The rules for the newly-sworn-in 113th Congress include language that essentially declares that the House, not a board of political appointees, will decide how Medicare spending decisions will be made. The rules state that the House will not be bound by PPACA requirements that IPAB recommendations cannot be changed or repealed, or that debate must be limited. In fact, the House, according to The Hill’s Healthwatch blog, would appear to be signaling that it won’t be compelled to bring the IPAB recommendations up for a vote at all.
Of course, the preferable policy alternative is to pass legislation to repeal the ill-conceived IPAB concept altogether. As we’ve discussed in this space previously, the IPAB structure will almost certainly lead to arbitrary Medicare cuts that are intended to hit numerical targets instead of improving the value of healthcare. Yes, Medicare can and must be made more cost-effective. Simply chopping away dollars, and likely reducing healthcare access and undermining quality improvements in the process, is not the way to do it.
But until Congress acts to do away with IPAB, the House’s new rules represent welcome preventive medicine.