Sebelius Stands Up for Medicare Cost-Cutting Panel at House Hearing
In a House Budget Committee hearing on Tuesday, HHS Secretary Kathleen Sebelius defended the Independent Payment Advisory Board created by the federal health reform law, CQ HealthBeat reports (Adams, CQ HealthBeat, 7/12).
Background on IPAB
IPAB will consist of 15 health experts tasked with making recommendations to Congress to reduce Medicare spending growth. IPAB is designed to include various health care stakeholders and researchers, including physicians, health economists, insurers and consumer advocates.
The panel has become steeped in controversy (California Healthline, 4/18).
Budget Committee Chair Paul Ryan (R-Wis.) asked Sebelius how IPAB can avoid disrupting care for beneficiaries through its suggested cuts (CQ HealthBeat, 7/12). She replied IPAB cannot make suggestions that would ration care, raise premiums, increase cost-sharing, cut benefits or alter Medicare eligibility (Zigmond, Modern Healthcare, 7/12). She also said IPAB recommendations "won't come into effect unless Congress hasn't taken action" (CQ HealthBeat, 7/12). Sebelius added, "If Congress is actually paying attention to the bottom line of Medicare, IPAB is irrelevant" (Ethridge, CQ Today, 7/12).
Republicans on the panel argued that Congress might be powerless to stop IPAB recommendations because of the reform law's stringent requirements for doing so.
Ryan also questioned whether the panel would cut payments to providers, which he said could cause providers to stop participating in Medicare (CQ HealthBeat, 7/12). He said that the board constitutes "political cover for politicians not to have to make decisions to cut reimbursements to providers" (CQ Today, 7/12).
Sebelius countered Ryan's questions by criticizing his Medicare proposal -- part of the House-passed GOP FY 2012 budget resolution (H Con Res 34) -- which would change Medicare from a fee-for-service program to one that would have beneficiaries purchase coverage on the private market. She said the proposal "would eliminate guaranteed benefits" for beneficiaries, which Ryan disputed (CQ HealthBeat, 7/12).
Rep. Chris Van Hollen (D-Md.), ranking member of the Budget Committee, said at the hearing that although some Democrats have reservations about IPAB, "I think we're united, and I think ultimately the American people are united, that [IPAB] is a better approach" for controlling Medicare costs.
The House Energy and Commerce Subcommittee on Health on Wednesday also is scheduled to hold a hearing to discuss IPAB (CQ Today, 7/12).
The following opinion pieces weigh in on the discussion over IPAB:
- Sen. John Cornyn (R-Texas), Politico: Panels similar to IPAB that are comprised of "unelected bureaucrats" currently "treat seniors poorly in other countries," such as Great Britain, Cornyn writes. He adds, "We should learn from [these] mistakes rather than repeat them." He notes that legislation (S 668) he introduced in the Senate would "repeal IPAB completely and defuse this bureaucratic bomb before it explodes" (Cornyn, Politico, 7/12).
- Paul Howard/Douglas Holtz-Eakin, Politico: "House hearings this week underscored growing support for repealing IPAB in Congress: from patients' groups, doctors, hospitals and drug and device manufacturers," write Howard --Â a senior fellow at the Manhattan Institute and director of its Center for Medical Progress --Â and Holtz-Eakin --Â president of the American Action Forum and former director of the Congressional Budget Office. They continue, "IPAB is fatally flawed, structured to punish innovative health care providers and threaten seniors' access to care -- while leaving the largest sources of Medicare spending untouched" (Howard/Holtz-Eakin, Politico, 7/12).
- Rep. Fred Upton (R-Mich.), Politico: "Allowing IPAB to operate outside the usual checks and balances has â¦ raised serious questions about whether this provision of the [reform] law is constitutional," Upton writes. Regardless, he writes, "by slashing or completely eliminating coverage for certain treatments, the effect of IPAB will be the refusal of health care for America's seniors" (Upton, Politico, 7/13).