Repeal of a Provision at the Heart of Rationing in the Obama Health Law Moves Forward in the House

By Jennifer Popik, JD,
Robert Powell Center for Medical Ethics

Jennifer Popik, J.D. Robert Powell Center for Medical Ethics

Today, the House of Representatives moved closer to  a floor vote to repeal one of the most controversial provisions of the Obama health care law (ObamaCare), the Independent Payment Advisory Board.

Integral to the Obama Administration’s stated mission to drive down what Americans choose to spend for life-saving and health-preserving health care, the IPAB is charged with a key role in suppressing health care spending by limiting what treatment doctors are allowed to give their patients.

With support from across the political spectrum, the House Energy and Commerce Committee, by a voice vote, approved H.R.452, which would repeal the IPAB. 

The legislation also falls under the jurisdiction of the House Rules and the Ways and Means committees, which held its own hearing today.  In that committee hearing, the IPAB drew fire from both Republicans and Democrats.  Even longtime proponent of single payer healthcare, Pete Stark (D-Ca), railed against the IPAB, saying it is a “provision I strongly oppose.” 

While the focus throughout this debate has been on the IPAB’s  authority to cut Medicare with very limited Congressional authority to override or alter those cuts, National Right to Life has been emphasizing a still graver concern – one at the core of rationing in ObamaCare. (See here.)

The health care law instructs the IPAB to make recommendations to limit what all Americans are legally allowed to spend for their health care to hold it below the rate of medical inflation.  The health care law then empowers the federal Department of Health and Human Services to implement these recommendations by imposing so-called “quality” and “efficiency” measures on health care providers. 

(The documentation can be found here.)

What happens to doctors who violate a “quality” standard by prescribing more lifesaving medical treatment than it permits? They 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 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. Repeal of IPAB is critically important to prevent this rationing of life-saving medical treatment.  

Despite the fact that the full House is likely to vote to repeal the IPAB, H.R. 452 is expected to stall in the Democratically-controlled Senate, or face an Obama veto.  Whether repeal is possible in 2013 will depend on the makeup of Congress in that year – and on who then occupies the White House.

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