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The Fight Against IPAB

With the debt ceiling debacle coming to an end, House Republicans may turn their attentions back to chipping away at Health Care Reform, more specifically the Independent Payment Advisory Board (IPAB) created by the law. IPABís goal is to lower Medicare spending, and the board would propose cuts much like the MedPAC panel currently does. The major difference and the reason Republicans oppose the panel is the amount of power IPAB is given. Unlike MedPACís suggestions, which are largely ignored by Congress, IPABís suggestions would become law unless Congress comes up with an alternative proposal that would save the same amount of money.

As we have seen in the past few months, it is difficult to get Congress to agree on spending cuts, especially to Medicare. The likelihood of getting Congress to agree on an alternative proposal cutting Medicare, especially if the reduction needed is large, seems slim. Many Republicans and some Democrats (Rep Allyson Schwartz (PA13) the No. 2 Democrat on the House Budget Committee and a highly esteemed voice on healthcare policy issues recently testified at a hearing against the board) fear that IPAB will weaken the healthcare system by drastically lowering provider payments. The lack of congressional oversight gives the 15 member panel what some argue is unprecedented power.

Although a repeal vote is planned for fall, it is unlikely to pass in the Senate and will surely be vetoed by President Obama. For opponents of IPAB, the fight is not likely to end there. If public opinion against IPAB strengthens or Republicans win the Senate in 2012, repeal before the board makes any changes is possible, since the first recommendation from the panel is set for 2014.

Given recent reports about the solvency of Medicare and Social Security, it seems that Medicare could benefit from some changes that help the program use resources more efficiently. But their also must be some middle option between the powerful IPAB and often ignored MedPAC panel. What do you think about the creation of the new board? Should it and will it be repealed?

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