Obamacare Repeal Effort Clouds Bid to Undo Health Law’s Medicare Cost Panel


Republicans’ effort to repeal the taxes and insurance regulations of Obamacare may prevent lawmakers from ending a controversial part of the health law affecting Medicare, health lobbyists and researchers told me recently.

The Independent Payment Advisory Board, or IPAB, was created by the Affordable Care Act, and it may take on added importance this summer, when federal officials release the latest Medicare spending projections. The board can cut Medicare spending without approval by Congress, which prompted Republicans to label it a “death panel” and sparked worries among physicians’ groups about where the cuts would fall.

Republicans like Senate Majority Whip John Cornyn (R-Texas) and Rep. Phil Roe (R-Tenn.) have led the charge to repeal the IPAB. However, to pass a repeal, lawmakers may need to find as much as $7 billion in cuts to Medicare spending and find support from some Senate Democrats, who have bristled at being left out of Obamacare repeal talks.

“It’s a prime example of how the legislative process can be overtaken by demons of its own creation,” Pete Sepp, president of the National Taxpayers Union, told me.

The 15-member IPAB panel has never been convened and has no members. Neither President Barack Obama nor President Donald Trump has nominated any IPAB members.

Any day now the CMS’s chief actuary is expected to determine if Medicare spending has reached the point where the IPAB would be triggered, Kip Piper, a consultant who specializes in Medicare and Medicaid policy, told me.

The triggering of the IPAB is likely to push lawmakers to act, Piper said, because it starts the clock on required cuts to Medicare. They’ll have only a few months until the process begins in earnest, he said.

Read my full story here.

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