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house Bill H.R. 1190

Medicare Cuts: Is it Time to Shut Down the Independent Payment Advisory Board?

Argument in favor

The IPAB was a terrible idea. They are an unelected panel that recommend spending cuts based on an arbitrary scale. It has too much power — if Congress doesn’t pass legislation meeting their reduction rates — Medicare spending is automatically cut.

Mary's Opinion
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06/18/2015
Medicare already pays practically nothing to doctors, making it very difficult for those who are forced to rely on Medicare get good care. Many doctors already refuse to accept patients who are on Medicare. I don't know how much worse you are planning to make it. It is already it is hard to find specialists who accept Medicare.
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Ann's Opinion
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06/18/2015
Cutting physician's fees is. one of the least equitable and effective ways to cut medical costs.
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Scott's Opinion
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08/07/2015
Medicine should not be about money, but about best healthcare outcomes.
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Argument opposed

Medicare spending needs to be reined in one way or another, it's increasing every year at an unsustainable rate. The IPAB ensures that the necessary cuts happen, even if Congress can't agree on a bill that would temper spending.

AndrewGVN's Opinion
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12/01/2015
Cutting social programs including medicare is not the answer to establish a balanced budget. The most effective way to have a better economy is if we cut military funding and close tax loopholes for big corporations, and use that revenue to provide resources such as better benefits with social security and free public college tuition.
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SouthernGal's Opinion
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03/07/2016
Another GOP plot to get rid of the ACA. When you decide to go single-payer, we can revisit this.
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Joel's Opinion
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06/23/2015
I don't think people are giving the aca enough time to fully implement. There are tons of good provisions that benefit the average person.
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What is House Bill H.R. 1190?

This bill would repeal sections of the Affordable Care Act (ACA) that established an Independent Payment Advisory Board (IPAB) — the group responsible for thinking of proposals to reduce Medicare spending. It would also restore the legal provisions that were repealed to create the IPAB.

The IPAB is a 15-member panel that recommends ways to keep Medicare spending from growing at a faster rate than the targets set by the Centers for Medicare and Medicaid Services (CMS). So, for example, the IPAB tries to reduce projected Medicare spending by:

  • 0.5 percent in 2015
  • 1.0 percent in 2016
  • 1.25 percent in 2017
  • 1.5 percent in 2018 and later. 
Under current law, if Congress doesn't pass a bill by August 15 (every year) that reaches the saving goals listed above, the IPAB’s recommendations are automatically put into affect. The IPAB can't offer recommendations that would ration care, increase revenues, change benefits, or modify eligibility. 

Impact

Seniors enrolled in Medicare and their families that would otherwise be affected by cuts to Medicare, Congress, CMS, the IPAB.

Cost of House Bill H.R. 1190

$7.10 Billion
The CBO estimates that implementing this bill would have no budgetary impact between 2015 and 2021, but would increase spending by $7.1 billion over the 2022-2025 period due to increased spending on Medicare. This amounts to about $1.8 billion annually for those years. The CBO calls this estimate “extremely uncertain” because it is unclear if the IPAB trigger for reducing Medicare spending that exists under current law would still be effective after a repeal. As a result, this CBO estimate covers a broad range of possible effects.

More Information

In-Depth: During the debate to repeal the Affordable Care Act, the IPAB was characterized as a ‘death panel’ resulting from fears that it would lead to the rationing of health care.

While the ACA explicitly bans the IPAB from suggesting rations on health care...there are lingering questions about the legal definition of ‘rationing’. The IPAB could indirectly ration care by cutting the compensation doctors receive for treating Medicare patients. Doctors have cited falling reimbursement rates for treating Medicare and Medicaid patients as a reason for declining to see those patients.

Those that favor keeping the IPAB point out that while it's an imperfect mechanism to restrain Medicare spending, it reduces Medicare spending. If you kill the IPAB, they contend, you put Medicare on an unsustainable trajectory.

Currently, this bill has 215 Republican and 20 Democratic cosponsors — and it passed the House Ways and Means Committee on a bipartisan vote of 31 to 8 with the support of seven Democrats. A letter from over 500 medical organizations has been circulated to members of Congress urging them to support efforts to repeal the IPAB.


Media

Summary by Eric Revell
(Photo Credit: Flickr user imfti)

AKA

Protecting Seniors' Access to Medicare Act of 2015

Official Title

To repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
      senate Committees
      Committee on Finance
  • The house Passed June 23rd, 2015
    Roll Call Vote 244 Yea / 154 Nay
      house Committees
      Committee on Energy and Commerce
      Health
      Committee on Rules
      Committee on Ways and Means
      Health
    IntroducedMarch 2nd, 2015

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    Medicare already pays practically nothing to doctors, making it very difficult for those who are forced to rely on Medicare get good care. Many doctors already refuse to accept patients who are on Medicare. I don't know how much worse you are planning to make it. It is already it is hard to find specialists who accept Medicare.
    Like (11)
    Follow
    Share
    Cutting physician's fees is. one of the least equitable and effective ways to cut medical costs.
    Like (4)
    Follow
    Share
    Cutting social programs including medicare is not the answer to establish a balanced budget. The most effective way to have a better economy is if we cut military funding and close tax loopholes for big corporations, and use that revenue to provide resources such as better benefits with social security and free public college tuition.
    Like (4)
    Follow
    Share
    Medicine should not be about money, but about best healthcare outcomes.
    Like (4)
    Follow
    Share
    Another GOP plot to get rid of the ACA. When you decide to go single-payer, we can revisit this.
    Like (3)
    Follow
    Share
    I don't think people are giving the aca enough time to fully implement. There are tons of good provisions that benefit the average person.
    Like (2)
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    Depending on Congress for anything seems like a foolish idea. Let the board stand. They at least must do something! Better than the folks we elect.
    Like (2)
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    This has always been a creepy thing to most seniors.
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    Harmful changes are coming to Medicare Part B that will threaten seniors’ access to doctors’ services and outpatient care. The Obama Administration is moving forward with an experimental program that could reduce payments for treatments – all without input from seniors or their healthcare providers. We are trying to stop these changes, but we need your help. Will you take a moment to contact your member of Congress and tell them you don’t want government bureaucrats dictating seniors’ access to care? The Obama Administration is empowering bureaucrats to decide seniors’ care. Congress should block these bureaucrats from dictating your care. We can’t let the Obama Administration get away with something that would have devastating consequences for America’s most vulnerable seniors. We must urge Congress to pass H.R. 5122 and H.R. 1190 – two bills that would save seniors from cuts to their Medicare benefits. Please take a moment to contact your member of Congress and tell them you don’t want government bureaucrats dictating seniors’ access to care. https://www.votervoice.net/Shares/BAAAAACoACXmLA7zWPP7FBA Thank you, Mike Shields President American Action Network
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    Why would we eliminate an organization set up to suggest recommendations to reduce costs?
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    Shouldn't cut spending old people need it
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    Single payer expand medicare
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    Again - cutting reimbursement has done nothing more than reduce the number of physicians accepting Medicare. NO procedure should be reimbursed less than it costs to provide the service. This is another example of how the govt cannot be trusted to run any program. I have reported Medicare fraud twice and nothing was ever done about it.
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    The greedy are trying awfully hard to prevent the American people to obtain medical care and pensions that they deserve to receive. Americans have built this country and deserve to have their medical bills paid.
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    The ipab presents a solution to cost over runs. The republicans have failed to present a viable alternative only a whiny series of complaints.
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    We elect representatives to make sure government doesn't abuse its powers. There should never be an independent panel making decisions for the people
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    If it avoids Congressional non action on Medicare Costs it should remain
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    It is important to rein in spending for Medicare, which has ballooned enormously since its existence. Unless Congress can suggest a better alternative, we must have this body which is steadily working to reduce our deficit.
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    I understand the doctors point of view that they don't want to treat patients with Medicare because they don't make enough however if your going to repeal a law make sure you have a solution in place to make up for its short comings.
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    MEDICARE should not be cut. The Obama administration should refund the 850 billion it stole from Medicare to fund the failed Affordable Care Act (Obamacare).
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