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Herger Opening Statement: Hearing on the Independent Payment Advisory Board

March 06, 2012

We are meeting today to hear from those who will be directly and adversely impacted by the so-called “Independent Payment Advisory Board” or “IPAB.”  In an era where the two political parties are best known for their deep divisions, this is one area where there appears to be bipartisan concern.

IPAB was created in the Democrats’ health care overhaul, and is designed to “reduce the per capita rate of growth in Medicare spending.”  That might sound benign, but when you peel back a couple of layers, it’s clear that IPAB is a real threat to Medicare beneficiaries’ health.

Those concerned about a government takeover of health care need look no further than IPAB.  If implemented, the board will consist of 15 unelected and unaccountable Washington bureaucrats.  IPAB is given the authority to meet in secret, make its decisions in secret, and it does not need to consider the perspective of Medicare patients or their health care providers.  To top it all off, IPAB’s rulings cannot be challenged in a court of law.

My good friend from California, the Ranking Member, Mr. Stark, characterized IPAB as “a mindless rate-cutting machine that sets [Medicare] up for unsustainable cuts that will endanger the health of America’s seniors and people with disabilities.”  I couldn’t have put it any more eloquently myself.  Yet despite the growing bipartisan opposition to this unaccountable board, the President once again proposed further expanding its authority in his most recent budget.

Why is IPAB so dangerous?  I have heard numerous concerns from patients and doctors, but to me, nothing is more troubling than IPAB’s ability to drive a wedge between Medicare beneficiaries and their doctors.

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.  As long as IPAB is allowed to exist, access to care for seniors and those with disabilities will forever be in jeopardy.

IPAB supporters argue that it cannot ration care.  What they won’t tell you is that the term “ration” is not defined anywhere in the Medicare statute.  This means that what is and is not rationing will be left to 15 faceless, unaccountable and unelected bureaucrats to decide.  

There is a better way.  Rather than endangering Medicare beneficiaries, we should empower them.  House Republicans have put forth such a plan.  Our plan would let beneficiaries, not bureaucrats, decide the coverage they want and need.

We have an excellent and diverse panel of witnesses here today, who will share their thoughts and concerns about IPAB.  We should all take note when patients and providers are in agreement that access to care is in jeopardy—where those concerns exist, it is our fiduciary responsibility to address them.