First of Two Hearing Regarding Controversial IPAB

By Jennifer Popik, JD

Rep. Paul Ryan (R-Wi.)

Today was the first of two hearings related to the controversial Independent Payment Advisory Board, or IPAB.  H.R. 452, the bill in the House which seeks to repeal the IPAB, has 161 cosponsors from both sides of the aisle. The IPAB is the central aspect of the Obama Health Care Law wherein an unelected 18-member board is given sweeping powers to limit what people are allowed to spend for health care.

In today’s Budget Committee hearing in H.R. 452, Health and Human Services Secretary Kathleen Sebelius and Rep. Chris Van Hollen (D-MD) vigorously defended the IPAB, sparring with committee Chair Paul Ryan (R-WI) and other Republicans.  Ryan repeatedly argued that allowing an unelected board to cut payments to providers would lead providers to stop offering their services, calling it rationing.

Witnesses on the panel who opposed IPAB focused on warning of the dangers of the board cutting payments to Medicare health care providers.  Even with wide opposition among health care provider groups and members of congress strangely, most critics focus only on its impact on Medicare.

As documented with specific quotes from the legislation at, the Obama Health Care Law  (“ObamaCare”) specifically directs the board to make “recommendations to slow the growth in national health expenditures” for private—not just governmentally funded—dollars devoted to health care. These recommendations are supposed to limit what ordinary citizens and their health insurance coverage can pay for medical treatment to force it below the rate of medical inflation.

To implement these recommendations, Sebelius’s Department of Health and Human Services is empowered to impose so-called “quality” and “efficiency” measures on health care providers. Doctors who violate a “quality” standard by prescribing more lifesaving medical treatment than it permits will be disqualified from contracting with any of the health insurance plans that individual Americans, under the Obama Health Care Law, will be mandated to purchase.

Few doctors would be able to remain in practice if subjected to that penalty. This means that treatment that a doctor and patient deem advisable to save that patient’s life or preserve or improve the patient’s health, but which exceeds the standard imposed by the government, will be denied even if the patient is willing and able to pay for it.

Sahil Kapur, writing for Inside Health Policy reports, “’I don’t think you’re going to see a whole lot of folks lining up to defend [IPAB],’ the staffer said, while also admitting that the issue is “politically sensitive” for Democrats because IPAB is important to the Obama administration.

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