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TABLE: Ryan’s 2009 Health Plan Included Two IPAB-Like Boards

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"TABLE: Ryan’s 2009 Health Plan Included Two IPAB-Like Boards"

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Rep. Paul Ryan is disputing claims that two independent advisory boards he introduced as part of his Patients’ Care Act (PCA) mirror the Affordable Care Act’s Independent Payment Advisory Board — a 15-member panel that he argues would “ration” health care. Responding to a blog post by the Incidental Economist’s Don Taylor that highlighted the similarities between Ryan’s boards and the IPAB, Conor Sweeney — the House Budget Committee’s Communications Director — sent Taylor a letter defending its chairman:

-The PCA empowers beneficiaries whereas the ACA enmpowers IPAB — “an unconstitutional board.”

-The ACA IPAB will “impose price controls, cut provider reimbursements, or make coverage determinations by fiat,” but the PCA’s Health Services Commission “exists solely for the purpose of encouraging transparency and proper metrics with respect to health care services.”

-IPAB will control Medicare costs by cutting provider reimbursements, “denying care for seniors.” Ryan’s Health Services Commission has “no authority to influence Medicare spending.”

But Ryan’s “differences” don’t mask the striking similarities between IPAB and the two boards proposed under the PCA — the Health Services Commission and the Forum for the Quality and Effectiveness in Health Care. In fact, in many ways, the PCA’s boards are more intrusive and hit providers harder. Read the pages 206-215 of the PCA Act here. ThinkProgress has also assembled a chart to illustrate:

PCA ACA
Board Structure Commission–5 members appointed by the President subject to Senate approval. No commissioner may engage in any other business, vocation, or employment; Forum–15 members chosen by the Commission 15 members appointed by the President subject to Senate approval. No member may engage in any other business, vocation, or employment.
Operative Element “The development and periodic review and updating of standards of quality, performance measures, and medical review criteria” Offer recommendations as to how to cut back on Medicare spending costs
Scope of Authority Entire health-care system; commissioners will select specific targets. Medicare
Recommendation Frequency Recommendations must be made once a year Recommendations are only made when the Medicare’s per capita expense exceeds its growth targets
Source of Enforcement Authority Commission works directly with the Secretary of Health and Human Services without congressional oversight. IPAB’s recommendations must be approved by Congress.
Guideline enforcement Exclude providers from federal health care programs or impose civil fines Impose cuts in health providers’ reimbursement benefits

-Sarah Bufkin

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