The House Energy and Commerce Health Committee yesterday voted 17 to 5 to approve a bill that repeals the hotly-debated Independent Payment Advisory Board (IPAB).
"IPAB is the exact opposite of transparency and accountability," said the subcommittee's chair, Rep. Joe Pitts (R-Pa.) in a statement about the vote. "It is merely another example of valuing centralized decision-making by government appointed experts over judgments that should be made between a doctor and patient."
Created by the Affordable Care Act, IPAB will consist of a 15-member panel that, beginning in 2015, will make binding recommendations to Congress to reduce spending if Medicare costs are projected to grow too quickly. For the years it doesn't make recommendations, the panel is required to make reports on national healthcare costs. Presently, the board doesn't exist.
[See also: IPAB: Why the U.S. needs it; IPAB on the firing line.]
Opponents of the IPAB argue that the board will have too much power, that there is no requirement for public comment to temper the board's recommendations and that the board will ration care.
Many members of the healthcare industry are among the opponents of IPAB, including the American Medical Association, which sent a letter to lawmakers earlier this week supporting the repeal.
"We appreciate the need to reduce the federal budget deficit and control the growth of spending in Medicare," wrote James Madara, MD, the AMA's executive vice president and CEO. "However, we believe that this can best be achieved by Congress working in a bipartisan manner to reform the delivery system and improve quality, access and efficiency. At a time in which Congress is struggling to eliminate the (sustainable growth rate), it does not make sense to allow another rigid formula to be implemented that risks a bigger set of problems for a broader cross-section of Medicare services."
Those supporting the board point out that the healthcare law prohibits the board from making any recommendations that would ration care and that while the president nominates board members, the Senate must approve them. They also note that the board's recommendations would only take effect if Congress doesn't act to control costs on its own.
A vote by the full House Energy and Commerce Committee hasn't yet been scheduled. The House Ways and Means health subcommittee has scheduled a hearing on March 6 to explore how the IPAB will impact the Medicare program, its beneficiaries and healthcare providers.
Follow HFN associate editor Stephanie Bouchard on Twitter @SBouchardHFN.