Obamacare's most potent tool for slashing health-care costs is likely to be taken down by the same forces it was designed to circumvent: Congress and the health-care industry.
The House Nov. 2 voted to repeal a controversial Medicare cost-cutting panel created under the Affordable Care Act Nov. 2. While Democratic leaders opposed the bill over financing concerns, lawmakers from both parties have long supported repealing the panel on the grounds it would take oversight of Medicare out of their hands.
“We can't allow unelected bureaucrats to make these decisions,” Rep. Raul Ruiz (D-Calif.), a main sponsor of the IPAB repeal bill in the House, told me recently.
The Independent Payment Advisory Board (IPAB) was designed to force lawmakers to make tough funding decisions for Medicare, the U.S. health-care program for the elderly and disabled, or forgo their authority if the cost of the program ever began to grow too quickly and became unsustainable.
That threat has proven widely unpopular, particularly among Republicans.
The 15-member panel has never been convened and has no members because Congress has never agreed to fund the panel and because Medicare cost increases so far have been less than the level called for under the law to trigger action by the payment board. Neither President Barack Obama nor President Donald Trump has nominated any IPAB members.
The panel, if convened, would propose cuts to Medicare payments that would bring Medicare back under target levels that are based on rates of consumer inflation and U.S. gross domestic product. IPAB's proposals would be sent to Congress for fast-track consideration that would become law unless lawmakers act to make their own cuts or block the panel's proposals.
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