Repeal of IPAB Advances

This week, a key committee in the House of Representatives advanced H.R. 849, the Protecting Seniors' Access to Medicare Act, bipartisan and ASA-supported legislation that would repeal the Independent Payment Advisory Board (IPAB). IPAB, a board of 15 non-elected and unaccountable appointees with sweeping powers to mandate across-the-board payment or other targeted reductions in Part B payments on top of cuts related to sequestration and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), was created by the Affordable Care Act (ACA).

In the Committee on Ways and Means, the bill passed, 24 ayes to 13 nays. The bill was also considered in Energy and Commerce Committee, but the Committee determined action on H.R. 849 was unnecessary, based on the vote by the Ways and Means Committee earlier. Next, the bill will be considered on the House floor. If the House were to approve of the bill, it would then advance to the Senate.

Meanwhile, in the other chamber, the U.S. Senate also included the repeal of IPAB into their budget resolution.

Repealing IPAB is one of ASA’s legislative priorities. ASA submitted letters to both House committees expressing strong support for H.R. 849. The board’s cuts will disproportionately fall on physicians, as some providers, including hospitals and hospice care, are exempt from IPAB cuts until 2020. Thus, along with the already unreasonably low Medicare payments for anesthesia services (“the 33 percent problem”), IPAB cuts could disproportionately impact physician anesthesiologists specifically.

ASA is a co-founder of the IPAB Repeal Coalition, which consists of over twenty specialty physician organizations representing more than 350,000 physicians and their patients. The coalition has been at the forefront of various legislative efforts to repeal IPAB. This week’s votes signal important progress in advancing this cause.

Energy and Commerce also considered several other pieces of legislation, including the Healthy Kids Act, which would extend funding for the State Children’s Health Insurance Program (CHIP). CHIP provides health coverage to targeted low-income children and pregnant women in families that have annual income above Medicaid eligibility levels but have no health insurance. Federal funding for CHIP expired September 30, 2017. This legislation provides five years of federal appropriations for CHIP, for FY2018 through FY2022.

ASA physician leaders and staff are tracking the progress of H.R. 849 closely, and will alert members of new developments.

ASA members are encouraged to contact their Representative to ask them to support H.R. 849 here.

Watch a recording of the Ways and Means mark up of H.R. 849 here.

Read ASA’s letters in support of H.R. 849 to the Committee on Ways and Means here.

Read ASA’s letters in support of H.R. 849 to the Energy and Commerce Committee here.