After more than two hours of debate on Wednesday, the House Ways and Means (W&M) Committee voted 24–13 to pass the Protecting Seniors’ Access to Medicare Act (H.R. 849) with bipartisan support. Sponsored by Reps. Phil Roe, MD (R-TN) and Raul Ruiz, MD (D-CA), H.R. 849 would repeal the Independent Payment Advisory Board (IPAB) and its authorities and powers as established in the Affordable Care Act (ACA). The bill was also scheduled to be marked up by the House Energy and Commerce (E&C) Committee later on Wednesday, but it was deemed unnecessary to do so as W&M already had passed the measure.
Debate among W&M Democrats centered around the Congressional Budget Office (CBO) estimate that the legislation would cost $17.5 billion over 10 years and does not include budgetary offsets to cover the expense. In addition, members of both parties—even those who support it—argued that repealing IPAB, which has not yet been triggered, is not a top priority.
As we have reported, IPAB comprises 15 unelected, unaccountable presidential appointees who will propose significant cuts to Medicare expenditures when spending grows too rapidly. Until now, spending growth has not kept pace with the threshold required to trigger IPAB, and no members have been named to the board. In the event that IPAB does not recommend Medicare cuts, the U.S. Secretary of Health and Human Services is empowered to recommend the spending cuts, which would automatically go into effect unless overridden by a supermajority vote in Congress.
Unless it is repealed, IPAB remains a threat to physicians and patients alike. ASCRS•ASOA and the entire medical community have consistently supported efforts to repeal IPAB since its inception. Prior to this week’s committee markup sessions, ASCRS, in conjunction with the Alliance of Specialty Medicine, sent letters of support for IPAB repeal and H.R. 849 to leaders of both W&M and E&C. In addition, hundreds of ASCRS and ASOA members have participated in grassroots advocacy to repeal IPAB, contacting their legislators and asking them to cosponsor and pass H.R. 849 and its companion bills in the Senate. We are appreciative of your efforts and will send more alerts as the bill continues to move through Congress.
Although H.R. 849 has passed out of committee, no date has been set for a vote on the House floor. However, Ways and Means Chairman Kevin Brady (R-TX) is confident that he and his colleagues will “find a way to advance [the bill] on the House floor, including as part of other 'must pass' pieces of legislation.” We will keep you updated.