Health care spending has been a controversial subject in the U.S., and the Independent Payment Advisory Board (IPAB) is at the heart of recent discussions.
"IPAB is among the worst features of the Affordable Care Act," Rep. Phil Roe (R-TN) told Patient Daily. "It is a board of unelected, unaccountable bureaucrats that have been granted sweeping powers to 'reduce the per capita rate of growth in Medicare spending.'”
The IPAB was created as a provision of the Affordable Care Act, which aims to decrease Medicare spending and not affect the coverage or quality of coverage that patients receive; However, the House of Representatives recently heard testimony that this may not be the case.
Despite current law, which prohibits the IPAB from making recommendations that ration care, the board could make spending reductions that could limit the care through undocumented criteria created by an unelected board.
"The power has been shifted from the committees and lawmakers, like us, who know these issues and are fighting for our patients and our providers at home, to either unelected bureaucrats’ 15 member board — we don’t know yet who they are — or some future or current health and human services sector, and the only way we can restore our common sense alternatives is to have enough votes to overcome a super majority of veto-proof majority," Rep. Kevin Brady (R-TX) said.
The House Ways and Means Committee recently met to discuss the IPAB and its implications, as well as Roe's legislation, the Protecting Seniors' Access to Medicare Act, which would repeal the IPAB. It advanced 24 to 13.
"I thank Chairman Kevin Brady for taking action to move this important legislation through the committee, and I hope this bill will be considered on the House floor where I’m confident it can receive overwhelming bipartisan support," Roe said.
Eight hundred organizations have pushed for Congress to terminate the IPAB, claiming that it could worsen access to Medicare for beneficiaries – an interesting prediction given that the board has no members, has never met and has never taken any action due to its nonoperational existence.
A recent piece by the Washington Post editorial board argued against IPAB repeal, saying it was a crucial element of the Affordable Care Act.
Kelly Fernandez of the Healthcare Leadership Council (HLC) told Patient Daily about some of the flaws involving the board and why it was not designed as a permanent fix.
"It is impossible to develop long-term, value-based reforms from a process that mandates spending cuts within a one-year timeframe, as IPAB does," Fernandez said. "It was not to improve the quality or accessibility of care for beneficiaries; from that perspective, IPAB was never a sound idea," Fernandez said.
Fernandez said there are other options for reform and that cutting Medicare spending was not an effective approach.
"Simply cutting spending will only restrict patients’ access to physicians and result in more health problems that will require expensive interventions down the road," Fernandez said.
Roe is optimistic about the future of the legislation and the response he received after the Ways and Means Committee hearing.
"This week’s action shows there is bipartisan concern about aspects of the Affordable Care Act, and I believe it is imperative we get rid of one of the worst features of this law before arbitrary cuts are implemented that harm seniors’ access to care," Roe said.