Challenging the IPAB Since the president signed his signature health care bill into law, we’ve seen many concerning parts of the law come to light. Perhaps one of the most troubling parts of Obamacare is the Independent Payment Advisory Board (IPAB). The IPAB will consist of fifteen unelected bureaucrats who are granted substantial powers to reduce Medicare spending. IPAB’s proposals could, for example, cut reimbursement for specific services that it determines not to be of high value. As a physician, I can tell you first-hand how troubling this mindset can be—every case is unique and must be treated that way. IPAB has two significant structural problems: it is both unaccountable and unworkable. The board is empowered to make recommendations regarding Medicare without any input from the Congress. IPAB proposals are to be considered using “fast track” procedures and, absent a three-fifths vote of the Senate, Congress can only modify the type of cuts, not the amount. Should Congress fail to act on the board’s recommendations, they automatically go into effect. To make matters worse, the IPAB is exempt from administrative or judicial review. President Obama’s former Budget Director Peter Orszag has called IPAB the “single biggest yielding of power to an independent entity since the creation of the Federal Reserve.” If the president does not nominate individuals to serve on the IPAB, or if the IPAB fails to recommend cuts, the law gives the Secretary of Health and Human Services the power to make changes unilaterally. We all should be able to agree that the power to affect seniors’ health care should not be concentrated in one person. Supporters of the board like to claim that IPAB is prevented from rationing care, and as far as the language of the law reads, that’s true. But dig a little deeper and you find out what’s prevented depends on how you define the word “rationing.” The IPAB is not allowed to say that a person should be denied a particular treatment or type of care, but the IPAB is allowed to cut payments to the physicians that perform these treatments low enough that the effect is no physician is willing to provide the treatment. In my view, the board is rationing care if the effect of their decisions is reduced access to needed care. Because I am so concerned about the power of this unelected board, I have been an outspoken opponent of the IPAB and have introduced legislation, H.R. 351, to repeal it. My bill has nearly 230 bipartisan cosponsors. Republican or Democrat, these representatives are committed to protecting seniors from the negative impact the IPAB could have on their health care. This week, I joined the Pacific Legal Foundation in leading an effort to file an amicus brief with the Supreme Court asking the court to take up a case filed by the Goldwater Institute concerning the IPAB’s constitutionality. The Goldwater Institute filed a petition last month requesting that the court take up the case on appeal. Unaccountable government boards set a dangerous precedent for future governing, and I strongly believe the Supreme Court should take a hard look at what this board can mean for health care in our country. Unfortunately, I believe this type of bureaucracy and overreach is not new for the administration. We’ve seen it time and time again, whether it’s through executive action on immigration reform or selective enforcement of our laws. I am concerned we cannot trust this administration to put the best interest of the American people before politics. The IPAB is a serious threat to seniors’ access to medical care, and I will continue to fight it both in Congress and by supporting legal challenges like the one the Goldwater Institute filed last month. Feel free to contact my office if we can be of assistance to you or your family. Our contact information can be found on our website, roe.house.gov.
Posted on: Sat, 06 Dec 2014 15:49:11 +0000
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