Urge Congress to Repeal IPAB Before It’s Too Late

2017-05-03 | , AACU Executive Office

On April 27, the AACU joined over 650 organizations representing all sectors of health care in a letter to Congress urging them to repeal the Independent Payment Advisory Board (IPAB). Given that the CMS Actuary may issue a determination as to whether IPAB has been triggered in the coming weeks, repealing IPAB has become absolutely critical.

With the House of Representatives in recess beginning this Friday until May 15 and both the House and Senate in recess the last week in May, the AACU is asking our members to reach out to their Representative and Senators while they are in district and urge them to support legislation to repeal the Independent Payment Advisory Board (IPAB).

Legislative Efforts to Repeal IPAB More Crucial Than Ever

Created under the Affordable Care Act as a cost control mechanism, IPAB is a 15-member panel of appointed officials who are responsible for reducing Medicare costs should they begin to rapidly rise. More specifically, if Medicare spending in a given year is expected to exceed its target growth rate, IPAB must develop and submit to Congress a proposal recommending cuts to Medicare expenses. Absent congressional intervention, the IPAB proposal automatically goes into effect.

If triggered, IPAB would have unprecedented authority to affect massive change in the health care system despite its minimal amount of congressional oversight. But even putting aside the fundamental legal concerns, an IPAB proposal would likely make significant cuts to Medicare payments for physicians and ultimately have a devastating effect on patient access to care.

As such, three federal bills to repeal IPAB were introduced in Congress this year: H.R. 849 (introduced by Reps. Phil Roe, MD [R-TN] and Raul Ruiz, MD [D-CA]), S. 251 (Democrat version introduced by Senator Ron Wyden [D-OR]), and S. 260 (Republican version introduced by Sen. John Cornyn [R-TX]).

While it hasn’t come yet, a determination as to whether IPAB is triggered could come any day now, making the repeal efforts more important than ever. Although neither President Obama nor President Trump have appointed any members to the board, authority to make Medicare budget cuts is transferred to the Secretary of Health and Human Services if the IPAB table is empty when triggered.

Letter to Congress Supporting Effort to Repeal IPAB

The AACU joined over 650 organizations in signing a letter urging Congress to repeal IPAB as soon as possible. The letter touched on the following points:

  • We are concerned that instead of pursuing long-term reforms, in an effort to achieve scoreable savings within a one-year time period, IPAB will likely consider short-term savings in the form of payment cuts for healthcare providers, which would have a devastating impact on patient access to care.   
  • By allowing the responsibility for enacting a massive change in the healthcare system from the legislative branch to the executive, the unelected board would have unprecedented authority to take actions that would affect a program that covers millions of our nation’s seniors and disabled individuals.
  • While we strongly support bringing greater cost-efficiency to the Medicare program and will continue to advocate for improving the quality of care delivered to Medicare beneficiaries, IPAB will achieve neither of these objectives and will only weaken, not strengthen, a program critical to the health and well-being of current and future beneficiaries.

Schedule In-District Meetings with Congressperson During Upcoming Recesses

The AACU is calling on its members to advocate for the repeal of IPAB by reaching out to their Representatives and Senators during the upcoming recesses and setting up a meeting to urge them to support the repeal bills (H.R. 849/S. 251/S. 260).

Please do not hesitate to contact the AACU and UROPAC staff for assistance in scheduling a visit with your Representative or Senator at their district office or even at your own practice if schedules allow. AACU/UROPAC staff members will help prepare you for these meetings by providing background information on the elected official and details on IPAB and repeal efforts.

Additional Resources