The Independent Payment Advisory Board (IPAB), a controversial feature of the Patient Protection and Affordable Care Act, was repealed Friday as part of a bipartisan budget act approved by both Houses of Congress and signed by President Donald Trump.
Since its establishment, physicians have been concerned that strict budgetary targets and other limitations imposed by the IPAB would ultimately threaten the ability of our nation’s seniors and disabled to obtain the health care they need when they need it. Thankfully, the panel, which was created to control Medicare growth, was never put into effect because Medicare spending didn't rise high enough in its nearly eight-year history to trigger a required board meeting.
The American College of Radiology (ACR) and most other medical specialty organizations have objected to the premise of the IPAB since its inception. Had the IPAB been invoked, the ACR feared the people’s elected federal representatives would lose their traditional power over Medicare payment policy. Instead, major health policy decisions would have shifted to 15 unelected and largely unaccountable IPAB board members. Even worse, if IPAB had failed to report recommendations, this power would have rested solely in the hands of a single person — the secretary of the Department of Health and Human Services.
Additionally, fewer than half of the IPAB members could have been health care providers, and none would have been permitted to be practicing physicians or be otherwise employed. Thus, the IPAB would have not only severely limited congressional authority, it would have eliminated the transparency of hearings, debate and meaningful opportunities for critical stakeholder input. Finally, IPAB decisions would not have been subject to judicial review, granting the board even more unprecedented powers.
The ACR applauds Congress for repealing the IPAB.
Overall, the budget agreement will fund the government until March 23 giving Congress time to agree on an omnibus spending bill covering the rest of the fiscal year. Other health care-related provisions include a four-year extension of the Children’s Health Insurance Program, a $2 billion budget increase for the National Institutes of Health, $7 billion for community health centers and $6 billion for a public health response to the opioid addiction crisis.