With seven Democrats crossing the aisle, the U.S. House of Representatives yesterday passed a bill to repeal a key component of the Affordable Care Act, the Independent Payment Advisory Board (IPAB).
The vote, like many others by the House over the past year, is likely to be little more than symbolic as the measure will almost certainly die in the Senate. The White House earlier this week also indicated that should the measure pass in a Senate vote, the bill would be vetoed.
Opponents of IPAB have long maintained the 15-member, independent panel would have too much of a say in determining Medicare payment rates. Supporters have long countered that this greatly overstates the power of IPAB, noting that IPAB's recommendations for cost containment would only come into play if Congress fails to act to keep Medicare spending in check.
In floor debate, California Republican Rep. Dan Lundgren clearly voiced the opposition's view: "The idea that 15 unelected individuals on the Independent Payment Advisory Board have been empowered by the so-called Patient Protection and Affordable Care Act to ration health care for seniors - and that's for all seniors - is as Orwellian as these titles crafted by the previous Congress to divert attention from what's really being done here."
Senator Jay Rockefeller (D - W.V.) meanwhile contended in a prepared statement that this was not so much about rationing as it was about protecting special interest groups.
"Today's House vote is a good example of what happens when special interests win – seniors lose," he said. "The Independent Payment Advisory Board was created to protect Medicare for seniors – by improving the quality of Medicare services and by extending the life of Medicare for years to come," the statement from Rockefeller read.
With little chance of progressing, the House vote now becomes political fodder for the upcoming campaign. Republicans are hoping that by going on the record as supporting IPAB (and therefor the entire health reform law, by proxy), it will provide Republicans with a solid campaign point among voters who take a dim view of the ACA.
However, that point may be somewhat muted, as the same bill to repeal IPAB also contained provisions that would serverely limit the amounts of malpractice settlements, capping them at $250,000.
A statement released by Rep. Bill Pascrell Jr., (D-N.J.) shows the many layers on which the battle will both be fought and defended in the coming election. Pascrell said he voted against the bill because of the cap on malpractice settlements, but then added: "I support repealing the Independent Payment Advisory Board, as do many Democrats. Make no mistake, I strongly support the Affordable Care Act. This bill will lower costs, strengthen Medicare, and provide 33 million uninsured Americans with health insurance. This is a tremendous accomplishment.
"But I have concerns with IPAB, including how it will operate and that it gives up important Congressional authority over pricing. Abdicating our responsibility is not the right thing to do for our seniors. I was elected by my constituents to protect Medicare. I supported this bill in the Ways and Means Committee, and I would love to support it on the floor. That's why it's so disappointing that the majority would abandon any semblance of compromise by attaching this sharply partisan medical malpractice proposal. Capping malpractice settlements limits patient protection."