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Drilling Down into IPAB: Pros and Cons

MedPageToday, 2012

It sounds like a new Apple product, but IPAB is actually a controversial board that is at the heart of House Republicans' efforts to upend the 2010 federal health law -- or at least make it a strong campaign issue.
The , created by the health law, is designed to help hold down costs in Medicare, the federal health program for seniors and the disabled.
But Republicans -- and some Democrats -- have , saying it would wind up rationing care and would eclipse congressional authority over Medicare.
Although earlier this month some prominent , when the GOP added a provision to limit medical malpractice awards, Democratic support appeared to evaporate.
The its support for IPAB and this week threatened to veto the Republican repeal should it pass the Senate.
Last year, President Barack Obama said it was critical to controlling the cost of Medicare, estimated at $524 billion in fiscal 2010.
Beginning with fiscal year 2015, if Medicare is projected to grow too quickly, IPAB will make binding recommendations to reduce spending.
Those recommendations will be sent to Capitol Hill at the beginning of the year, and if Congress doesn't like them, it must pass alternative cuts -- of the same size -- by August.
A supermajority of the Senate (at least two-thirds of those present) can also vote to amend the IPAB recommendations.
If Congress fails to act, the secretary of health and human services is required to implement the cuts.
The president is required to get suggestions from leaders of both parties in Congress in nominating 12 of the 15 appointees.