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house Bill H.R. 849

Should Congress Eliminate the Obamacare Board that Suggests Medicare Cuts?

Argument in favor

The IPAB was a terrible idea. They are an unelected panel that recommend spending cuts based on an arbitrary scale. It has too much power — if Congress doesn’t pass legislation meeting their reduction rates — Medicare spending is automatically cut.

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11/01/2017
This is a redundant department. CMS already has MedPAC that analyzes Medicare reimbursements every year to identify which sectors should have reimbursement rates decreased. This Board is literally unnecessary. Cut the duplicate department!
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Raymond 's Opinion
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11/01/2017
Obama care, How are we supposed too afford this. The Democrats knew that this would implode and yet they rammed it down the American tax payers throats. Remember this line by none other than Nancy Pelosi’s mouth. We have to vote on it before we see what’s inside!!! So all you people who want (FREE) health care. How are we going to pay for it? Eventually you will run out of other people’s money. Taxes are already through the roof. So please tell the rest of America where you are going to (STEAL) TAKE TAX. Their hard earned money from??? Please by all means tell us? And by the way this is not a right of any ones. Please show us in the Bill of rights and the Constitution where that is???
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Mart's Opinion
···
11/01/2017
Small steps, but about time you do what you were elected for, giant stomp on Obamacare
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Argument opposed

Medicare spending needs to be reined in one way or another, it's increasing every year at an unsustainable rate. The IPAB ensures that the necessary cuts happen, even if Congress can't agree on a bill that’d reduce spending.

Karalyn's Opinion
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11/01/2017
Fix ACA or provide healthcare for all first.
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Jill's Opinion
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11/01/2017
This is quite tiresome, the constant attacks by GOP on the ACA and anything that Obama had touched. I’ll repeat myself...fix the ACA while putting together Medicare for all.
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Courtney's Opinion
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11/01/2017
Leave Obamacare alone unless you want to replace it with single-payer.
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
      senate Committees
      Committee on Finance
  • The house Passed November 2nd, 2017
    Roll Call Vote 307 Yea / 111 Nay
      house Committees
      Committee on Energy and Commerce
      Health
      Committee on Rules
      Committee on Ways and Means
      Health
    IntroducedFebruary 3rd, 2017

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What is House Bill H.R. 849?

This bill would repeal sections of the Affordable Care Act (commonly known as Obamacare) that established an Independent Payment Advisory Board (IPAB) — the group responsible for thinking of proposals to reduce Medicare spending. It would also restore the legal provisions that were repealed to create the IPAB.

The IPAB is a 15-member panel that recommends ways to keep Medicare spending from growing at a faster rate than the targets set by the Centers for Medicare and Medicaid Services (CMS). So, for example, the IPAB would try to reduce projected Medicare spending by 1.25 percent in 2017 and 1.5 percent in 2018 and beyond. IPAB is only triggered when CMS predicts Medicare won’t hit those spending targets and Congress doesn’t act to meet them. That currently isn’t expected to happen until 2021, so IPAB isn’t operational at the moment.

Impact

Seniors enrolled in Medicare and their families that’d be affected by cuts to Medicare; Congress; CMS; and the IPAB.

Cost of House Bill H.R. 849

A current CBO cost estimate is unavailable.

More Information

In-DepthSponsoring Rep. Phil Roe (R-TN) introduced this bill to repeal the Independent Payment Advisory Board (IPAB):

“One of the most troubling parts of Obamacare is the Independent Payment Advisory Board (IPAB). If this Obamacare provision is triggered, this unelected, unaccountable board could have a widespread control over Medicare spending, potentially affecting seniors’ access to care without any accountability to Congress or the administration. While we certainly need to take steps to preserve Medicare for future generations, I have grave concerns the IPAB could drastically cut Medicare benefits with little to no Congressional oversight. There is bipartisan agreement in Congress that the IPAB is a gross overreach of power, and I am glad to introduce the House version of these bipartisan, bicameral measures to protect seniors’ access to Medicare while we work to repeal Obamacare as a whole.”

This legislation passed the House Ways and Means Committee on a 24-13 vote and has the support of 268 bipartisan cosponsors in the House, including 224 Republicans and 44 Democrats. During the last session of Congress a similar bill that was endorsed by 500 medical organizations passed the House on a 244-154 vote before stalling in the Senate.


Of NoteDuring the debate to repeal the Affordable Care Act, the IPAB was characterized as a ‘death panel’ resulting from fears that it would lead to the rationing of healthcare.

While the ACA bans the IPAB from rationing healthcare, there are lingering questions about the legal definition of ‘rationing’. The IPAB could indirectly ration care by cutting the compensation doctors receive for treating Medicare patients. Doctors have cited falling reimbursement rates for treating Medicare and Medicaid patients as a reason for declining to see those patients.

Those that favor keeping the IPAB point out that while it's an imperfect mechanism to restrain Medicare spending, it reduces Medicare spending. If you kill the IPAB, they contend, you put Medicare on an unsustainable trajectory.


Media:

Summary by Eric Revell

(Photo Credit: knape / iStock)

AKA

Protecting Seniors Access to Medicare Act

Official Title

To repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board.

    This is a redundant department. CMS already has MedPAC that analyzes Medicare reimbursements every year to identify which sectors should have reimbursement rates decreased. This Board is literally unnecessary. Cut the duplicate department!
    Like (86)
    Follow
    Share
    Fix ACA or provide healthcare for all first.
    Like (165)
    Follow
    Share
    This is quite tiresome, the constant attacks by GOP on the ACA and anything that Obama had touched. I’ll repeat myself...fix the ACA while putting together Medicare for all.
    Like (135)
    Follow
    Share
    Leave Obamacare alone unless you want to replace it with single-payer.
    Like (76)
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    No part of the mechanisms of this Act should be repealed unless and until the provisions of a replacement Act and mechanisms are known, debated and acceptable to your constituents.
    Like (66)
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    I am fascinated by the pure racist hatred of everything President Obama accomplished. When will republicans finally decide to put the well being of citizens above their own
    Like (39)
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    We need to control costs and this is one method to keep reasonable controls in place until we have Medicare for all.
    Like (35)
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    I could possibly support this action if I believed the intention was to improve the ACA, but it is not. This is a move designed to slowly dismantle the Affordable Care Act and return our country to a system where insurance companies make billions in profit off the backs of those they are supposed to be providing care for and tens of millions of Americans (including children) go without medical care.
    Like (33)
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    Obama care, How are we supposed too afford this. The Democrats knew that this would implode and yet they rammed it down the American tax payers throats. Remember this line by none other than Nancy Pelosi’s mouth. We have to vote on it before we see what’s inside!!! So all you people who want (FREE) health care. How are we going to pay for it? Eventually you will run out of other people’s money. Taxes are already through the roof. So please tell the rest of America where you are going to (STEAL) TAKE TAX. Their hard earned money from??? Please by all means tell us? And by the way this is not a right of any ones. Please show us in the Bill of rights and the Constitution where that is???
    Like (32)
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    I don’t trust Republicans to repeal anything.
    Like (28)
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    It’s simple, start fixing it instead of dismantling it while simultaneously moving forward to finally introducing a single payer healthcare system. EVERYONE has a right to healthcare. It’s nothing to even debate about.
    Like (18)
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    Fix the ACA now or pass legislation for Single Payer Healthcare. If saving money is a major issue for the Republican Party here’s something that would save money, stop Corporate Welcome, Give up your free Healthcare paid for by we the people, how about working a full calendar year like the average citizen then just working about 138 days for full paid. Write tax legislation that would make your Corporate donors pay their fare share of taxes. How about the administration stopping cabinet members from pimping the government with over blown budgets and travel expenses, etc.
    Like (15)
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    No! I'm perfectly OK with paying my share for everyone to get government health benefits, but you can't cut Medicaid, SNAP, and CHIP, just so the older voting bloc of boomers gets their benefits at the expense of younger generations. It appears as if the greatest generation gave birth to the most selfish generation. Find another way to fix the financial problems without adversely affecting younger generations.
    Like (14)
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    Small steps, but about time you do what you were elected for, giant stomp on Obamacare
    Like (13)
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    Obamacare hurts the middle class it rises the medical care cost no more Obamacare we done with Obamacare
    Like (12)
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    Fix the weaknesses in the ACA or work on MEDICARE for all! Don’t undermine the elements of ACA one step at a time. Not only does this affect the populations physical health- it’s affecting our financial health.
    Like (11)
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    Everything THAT President Obama needs to be on ash been of HISTORY and need to get MINERS Back TO WORKING MINING THIER CLAIMS
    Like (11)
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    Don’t dismantle the ACA, fix it!
    Like (11)
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    Here we go again. Piece by piece taking away protections and elements that support affordable healthcare as a right.
    Like (10)
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    Whether by design or by accident, the IPAB can impose taxes, appropriate funds, and ration care – with virtually no oversight from Congress, the president, the courts, or voters. It needs to be eliminated and a new, more viable system established to regulate, monitor, & control the expenditures of allocated funds of the program.
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