Cantor Says House May Again Consider Legislation to Repeal IPAB in Next Congress

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The House in 2013 may again consider legislation to repeal the Independent Payment Advisory Board (IPAB) in the health care reform law, House Majority Leader Eric Cantor (R-Va.) has told Republican colleagues.

In a Nov. 7 letter to fellow House members outlining his legislative priorities for the next Congress, Cantor said there are several pieces of legislation that, if approved by the House, may be able to clear the Senate. IPAB repeal was on that list.


 

“While it is unrealistic for us to expect the President to embrace our vision of Medicare reform or Obamacare repeal, it is equally unrealistic for the President to continue to insist that Obamacare is off the table, or that Medicare and Medicaid require nothing more than some additional provider cuts.”  

 

--House Majority Leader Eric Cantor

“There are some issues that I suspect [Senate Majority Leader Harry Reid (D-Nev.)] will have a difficult time compelling his members to oppose outright,” Cantor said.

“Therefore, if we successfully make the case publicly, bills that could reach the President's desk include: expanded work requirements for welfare programs, expanded domestic energy production, and repeal of IPAB,” he said. “When we gather at our retreat in January [2013], our Conference will need to further refine and agree upon this list of priorities.”

By a vote of 223-181, the House March 22 approved legislation repealing IPAB, which was created in the Affordable Care Act to control Medicare costs.

Seven Democrats joined 216 Republicans voting in favor of the bill (H.R. 5). To help offset the costs of repealing IPAB, the measure was combined with a bill that would place major limits on medical malpractice cases brought in state court (23 MCR 330, 3/23/12).

Senate Opposition.

However, the bill did not advance in the Democratic-controlled Senate. Democrats retained control of the Senate in the Nov. 6 elections, and Republicans retained control of the House.

The 15-member IPAB, appointed by the president and subject to Senate confirmation, would be empowered beginning in 2014 to impose limits on Medicare spending if costs grew faster than targets set in ACA.

The Congressional Budget Office has said the spending targets governing IPAB action are unlikely to be triggered until at least 2022, so the board might not make recommendations before then.

A plan proposed by IPAB, or an alternative proposed by the secretary of health and human services, would take effect unless Congress voted down the proposal under a fast-track procedure.

Supporters of IPAB say the board would save Medicare costs by removing congressional politics from decisions regarding reimbursements to Medicare providers.

Critics of IPAB say that, because ACA bars the board from restricting Medicare benefits, its only recourse would be to cut provider reimbursement rates, which could result in a loss of access to care.

Entitlement Reform.

Cantor also said the House could take action in the next Congress by “encouraging growth in medical research and life sciences by improving the regulatory system.”

He said entitlement reform and ACA funding should be on the table in negotiations for dealing with the so-called fiscal cliff, the package of spending cuts and tax increases due to be implemented in 2013.

“While it is unrealistic for us to expect the President to embrace our vision of Medicare reform or Obamacare repeal, it is equally unrealistic for the President to continue to insist that Obamacare is off the table, or that Medicare and Medicaid require nothing more than some additional provider cuts,” Cantor said.

He added: “We will measure entitlement savings on the basis of whether they are sustainable and whether they actually bend down the cost curve.”

By Steve Teske