There has been much debate and concern recently about a little-known agency called the Independent Payment Advisory Board (IPAB). This board is a significant aspect of the federal health reform bill (PPACA) created by President Obama. The IPAB does not yet exist, and its 15 board members have yet to be assigned. However, when the PPACA is enacted, this board of 15 unelected and unaccountable individuals will be given unprecedented (almost limitless) power over federal Medicare spending.
What is the IPAB?
The IPAB will be an agency consisting of 15 presidential appointees empowered to reduce Medicare spending. In theory, the overall goal of Medicare cost containment sounds great, because, as we all know, the current Medicare program is unsustainable. However, not much is known about the IPAB and what is known is concerning. For example, we know that the IPAB will be exempt from both administrative and judicial review, but we do not know why. Additionally, the 15 members of the IPAB are to be "health experts" appointed by the president, meaning that they will be bureaucrats, not practicing medical staff. Furthermore, although the IPAB is allowed to take comments from the public before it makes recommendations, it is not required to. Ultimately, it is only accountable to the president.
What will the IPAB do?
The IPAB will make recommendations and submit proposals for driving down Medicare costs. However, lowering these costs can realistically only be done through price controls that target provider reimbursement rates. Ultimately, as we’ve learned from Medicaid, this limiting of reimbursement rates to doctors will result in decreased access to physicians, fewer treatments provided and a decrease in the quality of health care. Moreover, the price-setting power of the IPAB will override any decisions made by physician and patient.
How will the IPAB do it?
The most frightening part about the IPAB is the method it can use to wield its power. First, it will have sovereignty over Congress. Congress can potentially counter IPAB recommendations, but only if Congress’s total proposed Medicare expenditures do not exceed the IPAB’s recommended levels. Neither the House nor the Senate may entertain a change to board recommendations unless the proposed change meets the aforementioned criteria. These restrictions may only be waived or suspended in the Senate by a 3/5 vote (supermajority). Additionally, IPAB recommendations must be processed by Congress on a shorter than normal timetable. This timetable limits the Senate’s debate time on amendments to board recommendations to one hour, superseding the Senate’s standing rule requiring 60 votes to invoke cloture in case of a filibuster. This basically means that this unelected, unaccountable board has the force of law.
————————————————————————————————————
Who Is Taking ObamaCare Money & How Much
Unprecedented Number of Veto Over-Rides by NC Senate
Why Medicaid Should Be Easier to Fix Than Entitlements
Click here for the Healthcare Update archive
