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IPAB Repeal Legislation Clears Key House Committees

March 9, 2012—The House Energy and Commerce and Ways and Means committees passed by voice vote, without request for a roll call vote, the Medicare Decisions Accountability Act of 2011 (H.R. 452). This legislation would repeal the Independent Payment Advisory Board (IPAB), a 15-member unelected panel created by the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152), tasked with making recommendations to Congress that restrain Medicare spending growth beginning in 2013. The Energy and Commerce Health Subcommittee Feb. 29 passed the bill with bipartisan support [see Washington Highlights, March 2].     

Committee Chair Fred Upton (R-Mich.) opened the March 6 Energy and Commerce markup saying, “Health care decisions belong in the hands of patients and doctors rather than an unaccountable panel of government-appointed experts….IPAB is not the way to protect Medicare, and I am pleased to see us working in a bipartisan fashion to repeal it.” Disagreeing with Chairman Upton that IPAB would hurt Medicare beneficiaries, Ranking Member Henry Waxman (D-Calif.) said, “H.R. 452 is part of this Republican assault on Medicare. It would repeal the Medicare Independent Payment Advisory Board, which serves as a backstop to help keep Medicare affordable for seniors.”

The House Ways and Means Health Subcommittee March 6 also held a hearing to discuss IPAB, and the full committee approved H.R. 452 on March 8. During the hearing, Subcommittee Chair Wally Herger (R-Calif.) said, “There is nothing in the Democrats’ health care law preventing IPAB from slashing Medicare reimbursements for services or procedures that IPAB members feel are unnecessary or ineffective to levels so low that no physician would be willing to provide such care.” Subcommittee Ranking Member Pete Stark (D-Calif.) began by saying he believes the ACA is working; however, he continued that “the Affordable Care Act is a large bill with many provisions…. To that point, the [IPAB] is a provision I strongly oppose.”

Ways and Means Chair Dave Camp (R-Mich.) opened the H.R. 452 markup by commending the support from both sides of the isle for IPAB repeal, stating, “The most unifying feature of the IPAB is the strong bipartisan support for its repeal.” He added, “Regardless of political affiliation, I believe that we all share a similar perspective about Medicare and the role that Congress plays in the future of the program.” However, Ranking Member Sander Levin (D-Mich.) expressed the suspicion of many Democrats that the legislation is simply another Republican assault on the ACA and urged his colleagues to vote against the measure “[b]ecause health reform must be sustained, and if needed, improved or reformed, not repealed.” 

The Congressional Budget Office (CBO) estimates the IPAB repeal would cost $3.1 billion over 10 years, adding to Democratic concerns about the timing and purpose of the repeal and leading them to question why Republicans failed to include any offsets.  However, Republicans pointed out that “pay-fors” will be added at a later time, most likely when the bill goes before the House Rules Committee. 

Further action on H.R. 452 has not yet been scheduled, but the IPAB repeal could come to the House floor as soon as the week of March 19. 


Len Marquez
Director, Government Relations
Telephone: 202-862-6281


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