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Letter to Capitol Hill Says IPAB, Once Implemented, “Would Be Devastating to Patients” and Will Shift Costs to Consumers, Employers

WASHINGTON – Over 500 national and state-based organizations, representing virtually every state in the union, have signed a letter to Congress calling upon lawmakers to repeal the Independent Payment Advisory Board (IPAB) provision of the Affordable Care Act, an entity they say would impair Medicare beneficiaries’ access to care and remove public accountability from the Medicare decisionmaking process. 

The letter reaches Congress at a time in which bipartisan IPAB repeal legislation in the U.S. House – the “Protecting Seniors’ Access to Medicare Act” introduced by Representatives Phil Roe (R-TN) and Linda Sanchez (D-CA) – currently has 220 additional cosponsors, a majority of the House. 

IPAB is a board, comprised of executive branch appointees, which would be charged with making cuts to Medicare expenditures if program spending reaches a certain level established by statute.  Once the Secretary of Health and Human Services implements the IPAB recommendations, the action is not subject to administrative or judicial review.  If IPAB members are not appointed by the President, or IPAB does not act to cut Medicare spending within the law’s required timeframe, the board’s powers are automatically shifted to the HHS Secretary. 

As the letter to Congress put it, “An unelected board without adequate oversight or accountability would be taking actions historically reserved for the public’s elected representatives in the U.S. House and Senate.” 

The letter points out that IPAB must achieve mandated savings within a one-year time period.  This means that, instead of pursuing long-term reforms to strengthen Medicare, IPAB would be more likely to achieve its targets by cutting payments to healthcare providers. 

“This would be devastating for patients, affecting access to care and innovative therapies,” the groups wrote, pointing out that the number of physicians unable to accept new Medicare patients due to low reimbursement rates has been increasing. “ IPAB-generated payment reductions would only increase the access difficulties faced by too many Medicare beneficiaries.  Furthermore, payment reductions to Medicare providers will almost certainly result in a shifting of health costs to employers and consumers in the private sector.” 

The letter concludes, “We strongly support bringing greater cost-efficiency to the Medicare program.  We also advocate continuing efforts to improve the quality of care delivered to Medicare beneficiaries.  The Independent Payment Advisory Board 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.” 

Among the more than 500 organizations signing the letter to Congress are the Healthcare Leadership Council, American Medical Association, Easter Seals, National Alliance on Mental Illness, National Association of Manufacturers, National Minority Quality Forum, Parkinson’s Association, U.S. Chamber of Commerce and Vietnam Veterans of America. 

Healthcare Leadership Council President Mary R. Grealy said, “The voices of this many organizations representing tens of millions of Americans, combined with a majority of the U.S. House of Representatives, send a clear signal that the IPAB approach to addressing Medicare’s future is unworkable and unacceptable.  We need to focus on bringing greater value and sustainability to Medicare, not arbitrarily swinging an ax that will do great harm to those who depend on this program.”