Two more Democrats, Reps. Loretta Sanchez (D-CA) and Tim Bishop (D-NY) have signed on to Rep. Phil Roe’s (R-TN) bill to repeal the Independent Payment Advisory Board (IPAB) — a 15-member cost-cutting commission established by the Affordable Care Act. The Board is tasked with making binding recommendations to Congress for lowering health care spending if costs increase beyond a certain point.
“IPAB shifts health-care decision-making power away from the patient; it will operate without transparency or accountability, bypassing all congressional oversight; and it places the focus on slashing Medicare costs, rather than on improving the quality of care,” Roe said earlier this month. “I am pleased there is growing bipartisan support to repeal the IPAB because it will lead to rationing of care by government bureaucrats.” But a ThinkProgress analysis of the 198 Democratic and Republican lawmakers who are co-sponsoring the measure shows that 138 members also voted in favor of yesterday’s debt ceiling bill, a measure which could have a far more substantial effect on “slashing Medicare” than the ACA’s IPAB board:
– 138 co-sponsors of Roe’s IPAB repeal bill voted for the debt ceiling deal; 6 Democrats and 132 Republicans.
– 60 co-sponsors of Roe’s IPAB repeal bill voted against the debt ceiling deal; 3 Democrats and 57 Republicans.
The deal reached yesterday would raise the debt ceiling through 2012 by immediately cutting $917 billion from mostly discretionary spending and establishing a joint congressional committee to recommend $1.2 trillion to $1.5 trillion in additional cuts. And while Medicare is protected from the first round of reductions, it will likely be targeted in the second. In fact, the committee is free for slash provider reimbursements or make a wide array of benefit cuts from raising the eligibility age to offering premium support to means testing the program.
If the committee’s recommendations are not enacted by December 23, 2011, across the board spending cuts are triggered, affecting up to 2 percent of Medicare’s total spending, but excluding Medicare benefits. Still, the committee’s cuts or the triggered reductions would do far more to “slash” Medicare expenditures and potentially undermine seniors’ access to Medicare than the IPAB. Here is why (after the jump):
1) Congress can fully replace an IPAB recommendation with a reform that saves the same amount of money or muster both a supermajority and a presidential signature to stop IPAB from acting >> Congress can control the committee’s recommendations, but cannot stop the triggers from going into effect.
2) IPAB is prohibited from including any recommendation that would: (1) ration health care; (2) raise revenues or increase Medicare beneficiary premiums or cost sharing; or (3) otherwise restrict benefits or modify eligibility criteria >> While the triggers can’t make cuts to Medicare benefits, the committee is not restricted in what it eliminates from the program.
3) Lawmakers can pre-empt the IPAB by passing their own cost-control legislation >> The “trigger” cuts are enacted automatically unless the committee produces a compromise.
4) The IPAB is comprised of Senate-confirmed medical experts and consumer advocates >> The committee will include politicians with limited health care backgrounds.