It’s Time to Repeal the IPAB

As a physician who spent more than thirty years caring for patients, I have many concerns about the president’s health care law. Since the president signed ObamaCare, we’ve seen many parts of this deeply flawed law negatively impact both patients and providers, but one of the most troubling parts of the Affordable Care Act is the Independent Payment Advisory Board (IPAB).

The IPAB will consist of fifteen unelected bureaucrats tasked with finding savings in Medicare. Unfortunately, the board is empowered to make recommendations regarding Medicare without any input from the Congress. IPAB proposals will 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.”

It is also concerning that, 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. There is bipartisan agreement in Congress that the power to affect seniors’ health care should not be concentrated in one person. We should protect Medicare by implementing commonsense reforms, but those reforms should be openly debated in Congress by elected officials, not mandated by backroom bureaucrats that were appointed by the president.

Supporters of the board and the president’s health care law claim that IPAB is prevented from rationing care, and as far as the language of the law reads, that’s true. But much 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 board 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. I believe the board is rationing care if their decisions result in reduce access to care.

I have consistently pushed for repealing the IPAB and was proud to introduce H.R. 1190, the Protecting Seniors’ Access to Medicare Act, with Rep. Linda Sánchez (D-CA) earlier this year. This bill has more than 230 bipartisan cosponsors and was approved by the House Ways and Means Committee with bipartisan support. While Rep. Sánchez and I have differing views on ObamaCare as a whole, I very much appreciate her leadership on this important bill. On Tuesday, the House will vote on H.R. 1190, and I hope the Senate will also consider the bill soon.

— Representative Phil Roe, M.D. (R-TN)

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