Weekly Columns

Protecting Seniors’ Access to Medicare

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Washington, January 23, 2013 | Tiffany McGuffee (202-226-8072) | comments

President Obama’s Affordable Care Act (ACA), which ironically is unaffordable, is also bad medicine for America. The president predicted that after passing the ACA premiums would be cut by $2,500, but instead the average premium has increased by more than $3,000. You’ve probably read about the 21 new taxes the law imposes and how the law cuts more than $700 billion out of Medicare to fund a new entitlement. But one of the worst parts of the ACA is one you may not know about—the creation of an entity called the Independent Payment Advisory Board (IPAB).

The IPAB is an unelected, unaccountable bureaucracy that has been granted sweeping powers to reduce Medicare spending. This denial-of-care board will become operational on April 30 of this year when Medicare’s Chief Actuary will make a determination as to whether Medicare spending will exceed an arbitrary target set by formula. In the event that spending grows faster than permitted, the IPAB will propose a series of Medicare cuts. Given that Medicare only pays physicians only 80% of what private insurers do, any additional cuts could severely limit patients’ access to care. This is because proposed cuts will likely reduce payments to physicians and other health care providers.

IPAB proposals are to be considered using “fast track” procedures and—absent a three-fifths vote of the Senate—Congress can only modify the type of cuts, not the amount. Should Congress fail to act on the board’s recommendations, they automatically go into effect. To make matters worse, the IPAB is exempt from administrative or judicial review.

If the president does not nominate individuals to serve on the IPAB—or if the IPAB fails to recommend cuts—the law gives the Secretary of Health and Human Services the power to make changes unilaterally. We all should be able to agree that the power to affect seniors’ health care should not be concentrated in one person.

Supporters of the board like to claim that IPAB is prevented from rationing care, and as far as the language of the law reads, that’s true.  But dig a little deeper and you find out what’s prevented depends on how you define the word “rationing.”  The IPAB is not allowed to say that a person should be denied a particular treatment or type of care, but the IPAB is allowed to cut payments to the physicians that perform these treatments low enough that the effect is no physician is willing to provide the treatment.  In my view, the board is rationing care if the effect of their decisions is reduced access to needed care. 

As a physician with more than 30 years of experience, I find the ability of this board to intervene in the patient-doctor relationship particularly troubling. Because of these concerns, today I reintroduced the Protecting Seniors’ Access to Medicare Act, my legislation to repeal the IPAB. This bipartisan bill passed the House last Congress and had the support of members on both sides of the aisle. This Congress, the bill was introduced with over 80 cosponsors, including five democrats. I believe my bill is a testament to the fact that members of Congress can put party politics aside, come together and do what’s right for our seniors. I will continue to push for a full repeal of the IPAB, and I look forward to working with my colleagues—both Republicans and Democrats—to protect and preserve Medicare.

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