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Obama’s Deficit Plan: Inject IPAB With Steroids

- September 21, 2011

Deficit Plan Gives More Power To ObamaCare’s Board Of Unelected Bureaucrats

“The Health Care Savings In President Obama’s $3 Trillion Deficit-Reduction Plan Include Proposals That Are Sure To Spark Fights With States, Republicans And Several Health Care Industries.” (Sam Baker, “Obama Health Cuts To Spark Fights With States, GOP, Industry Groups,” The Hill’s Health Watch,” 9/19/11)

Obama’s Deficit Reduction Plan Calls For Strengthening The Controversial Independent Payment Advisory Board (IPAB) Of Unelected Bureaucrats Charged With Making Changes To Seniors’ Medicare Benefits. “The president also wants to strengthen the Independent Payment Advisory Board by reducing its growth rate target from GDP per capita plus 1 percent to plus 0.5 percent. The board, created by the health law, would have more power to consider enforcement mechanisms and value-based benefit design. The IPAB portion is likely to face strong opposition from Capitol Hill. Republicans are universally opposed to the panel, and several House Democrats have come out against it.” (Jennifer Haberkorn, “Obama Links Entitlements To Taxes,” Politico, 9/19/11)

Under Obama’s Plan, IPAB Will “Kick In” Earlier According To Obama’s Deficit Reduction Plan. “The plan proposes strengthening the Independent Payment Advisory Board (IPAB) — a cost-cutting panel created by healthcare reform that Republicans have said will ‘ration’ care. Obama’s proposal would allow the IPAB to kick in earlier.” (Sam Baker, “Obama Health Cuts To Spark Fights With States, GOP, Industry Groups,” The Hill’s Health Watch,” 9/19/11)

  • Obama’s Plan Requires IPAB To Recommend Medicare Changes If The Program’s Growth Rate Exceeds 0.5 Percent, Instead Of The Original One Percent Called For In ObamaCare. “Among the other items in the plan is a proposal to strengthen the Independent Payment Advisory Board (IPAB). It would require the board to recommend Medicare changes to Congress if the program’s growth rate exceeds that of GDP by 0.5 percentage points, rather than one percentage point as called for by the ACA. In addition, the board would be given the ability to consider value-based design elements for the Medicare benefit.” (Austin Frakt, “Medicare Policy And Politics: The Obama Debt Reduction Plan,” Health Affairs Blog, 9/19/11)

If Approved, Obama’s Plan For IPAB Could Force Further Cuts To Medical Providers. “Obama also wants to give additional authority to a new agency called the Independent Payment Advisory Board, which could force further cuts for medical providers.” (“Obama’s Deficit Plan Targets Drug Companies, Hospitals And Future Medicare Beneficiaries,” The Associated Press, 9/20/11)

STRENGTHENING IPAB WILL CAUSE PROBLEMS FOR MEDICARE BENEFICIARIES

HHS Secretary Kathleen Sebelius Admits That IPAB Threatens Seniors’ Access To Certain Procedures. “‘If Congress accepted the recommendations and made the decision that cuts in dialysis were appropriate,’ Sebelius replied, ‘I assume there could be some providers who would decide that would not be a service they would any longer deliver...’” (Kathleen Sebelius, House Energy And Commerce Committee’s Health Subcommittee, Testimony,  7/13/11, 0:57:23/4:54:54)

With IPAB, Obama Is Not Reducing Costs But “Limiting Or Denying Care.” “His plan: Use the Independent Payment Advisory Board to limit care and squeeze doctors and hospitals. In other words, he’s not reducing costs; he is limiting or denying care.” (Jennifer Rubin, “Obama’s Reverse Course On The Debt,” The Washington Post’s Right Turn Blog,” 9/19/11)

Critics Of IPAB Say It Could “Stifle” Future Medical Innovations And Make Providers Limit Access To Medicare Patients.  “Critics say their concerns can't be dismissed as easily as that, because IPAB is an attempt to cap Medicare spending. A stingy approach could stifle promising new medical innovations. And if IPAB leads to steep payment cuts, doctors and other providers will be reluctant to take Medicare patients, limiting access even without explicit rationing.” (Ricardo Alonso-Zaldivar, “Big Brouhaha Over Obscure Medicare Board,” The Associated Press, 7/18/11)

Even Democrats Argue That IPAB “Could Arbitrarily Cut Services To Medicare Patients And Payments To Providers.”  “But some Democrats, as well as most Republicans and health care providers argue the panel could arbitrarily cut services to Medicare patients and payments to providers with little congressional oversight.” (Jennifer Haberkorn, “Democrats Split On Independent Payment Advisory Board,” Politico, 7/10/11)

  • IPAB Is Causing A Wedge Between Obama And Congressional Democrats. “For the past year, Democrats have been mostly united on health care issues, especially in the face of Republican efforts to repeal President Barack Obama’s landmark law. But this week, House Republicans plan to fire their opening salvos against the Independent Payment Advisory Board — an issue on which Democrats are far from united.  Republicans plan to launch new attacks on the board in two congressional hearings. Democrats are divided over whether to support the health law at all costs or to allow Republicans an opening to repeal a provision.” (Jennifer Haberkorn, “Democrats Split On Independent Payment Advisory Board,” Politico, 7/10/11)

DEMOCRATS AND HEALTH GROUPS OPPOSE IPAB

Strengthening IPAB Is More Controversial As Democrats Work To Repeal It. “Some proposals will be controversial, such as the White House’s reiterated commitment to strengthening the Independent Payment Advisory Board (even as some house Democrats work to repeal it).” (Sarah Kliff, “How The White House Would Save $320 Billion In Health-Care Costs,” The Washington Post’s Wonk Blog,” 9/19/11)

  • Representative Frank Pallone, Jr. (D-NJ): “[U]ltimately The IPAB Is Going To Get Repealed.” (N.C. Aizenman, “Republicans, Health Industry Lobbyists Target Medicare Cost-Cutting Board,” The Washington Post, 8/13/11)

Currently, 12 House Democrats Have Co-Sponsored Legislation That Would Repeal IPAB. (H.R. 452, Introduced 1/26/11)

“More Than 70 House Democrats Opposed The IPAB When The Health Care Law Was Being Drafted…” “More than 70 House Democrats opposed the IPAB when the health-care law was being drafted, keeping it out of the House version of the bill. Eleven have signed on as co-sponsors of a Republican-authored bill to eliminate the IPAB.” (N.C. Aizenman, “Republicans, Health Industry Lobbyists Target Medicare Cost-Cutting Board,” The Washington Post, 8/13/11)

Representative Pete Stark (D-CA):  “IPAB Is A Dangerous Provision…Will Endanger The Health Of America’s Seniors And People With Disabilities.”  “By statute, this Commission would be required to hold Medicare spending to an arbitrary and unrealistic growth rateIt is a mindless-rate cutting machine that sets the program up for unsustainable cuts. That will endanger the health of America’s seniors and people with disabilities. It is an unprecedented abrogation of Congressional authority to an unelected, unaccountable body of so-called experts. I intend to work tirelessly to mitigate the damage that will be caused by IPAB.” (Press Release, “Statement Of Congressman Pete Stark Supporting Health Care Reform,” Congressman Pete Stark, 3/21/10)

Representative Allyson Schwartz (D-PA): “IPAB Brings Unpredictability And Uncertainty To Providers And Has The Potential For Stifling Innovation And Collaboration.” “We all agree that Medicare costs must be contained and that the payment system is flawed and needs to be replaced. But simply cutting reimbursements is not the answer. IPAB brings unpredictability and uncertainty to providers and has the potential for stifling innovation and collaboration.” (Rep. Allyson Schwartz, Op-Ed “Opposing View: Repeal Medicare Board,” USA Today, 5/23/2011)

Former Democrat House Majority Leader Dick Gephardt:  “It will propose cuts to Medicare that Congress can override only with supermajority votes, an unnecessarily high and unrealistic bar. Just as important, these cuts are likely to have devastating consequences for the seniors and disabled Americans who are Medicare's beneficiaries because, while technically forbidden from rationing care, the Board will be able to set payment rates for some treatments so low that no doctor or hospital or other healthcare professional would provide them.” (Dick Gephardt, Op-Ed, “Medicare Must Remain A Responsibility Of Congress,” Huffington Post, 6/21/11)

  •  “Also Of Great Concern To Me Is The Possibility That Untenably Low Payments Will Have A Chilling Effect On The Research And Development Necessary To Spur What Promises To Be The Next Great Breakthrough In Prescription Drug Treatment…” (Dick Gephardt, Op-Ed, “Medicare Must Remain A Responsibility Of Congress,” Huffington Post, 6/21/11)

The IPAB Is So Unpopular That 270 Health Care Groups Support Repeal.  “All told, some 270 stakeholder groups signed a letter to members of Congress urging them to repeal the Independent Payment Advisory Board. The IPAB is a panel of experts, appointed by the President, that will have the power to cut Medicare payments.” (Sam Baker, 270 Health Care Groups Back IPAB Repeal,” The Hill’s Health Watch,” 6/24/11)

  • Organizations That Oppose IPAB Represent Doctors, Health Care Providers And Many Others In The Health Care Industry. “The organizations represent doctors, other health care providers, employers, drug and medical device manufacturers and some disease-specific advocates — in short, a robust cross-section of the groups that stand to lose as a new and powerful body looks for Medicare savings.” (Sam Baker, 270 Health Care Groups Back IPAB Repeal,” The Hill’s Health Watch,” 6/24/11)

Nearly Every Health Industry Opposes The IPAB.  “An independent panel authorized by President Barack Obama’s health care law to control excessive Medicare costs increases is drawing heavy fire from Republicans.  Nearly every health industry lobbying group is pushing for its repeal, as are some consumer advocates.  GOP lawmakers call it a rationing panel, and at least one has suggested seniors will die from its decisions.” (Ricardo Alonso-Zaldivar, “Big Brouhaha Over Obscure Medicare Board,” The Associated Press, 7/18/11)

OBAMA HAS WANTED TO STRENGTHEN THE IPAB THIS WHOLE TIME

JULY 2011 - Obama Proposed Increasing IPAB’s Authority.  “Obama in April proposed increasing the IPAB's authority as an alternative to House Republicans' Medicare overhaul. The president laid out a proposal he said would reduce the deficit by $4 trillion over 12 years, in large part by lowering the threshold when the IPAB kicks in (under the law, the IPAB issues recommendations that Congress must act on if the growth of Medicare costs exceeds a specific target).” (Julian Pecquet, “Key Democrat Testifies Against Healthcare Reform Bill’s Cost-Control Panel, The Hill’s Health Watch,”  7/13/11)


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