Medicare Monday: What is IPAB, and why is it bad for patients?

In 2017, the Independent Payment Advisory Board (IPAB) could finally go into effect and come between patients and their health care providers. This week, we’re looking into this dangerous body.  

What is IPAB? 

Created as part of the Affordable Care Act, the Independent Payment Advisory Board consists of 15 members selected by the President and confirmed by the Senate. IPAB is charged with proposing cuts to Medicare if spending exceeds a certain growth target. (That target is estimated to be reached in 2017.) If no board is appointed, these powers transfer automatically to the Secretary of Health and Human Services. To date, a board has not been appointed or confirmed.  

Why is IPAB bad for patients?  

Cuts proposed by IPAB would be mandatory and largely unchecked, giving the board – or the Secretary of Health and Human Services – the power to make widespread changes to Medicare without congressional approval. While other branches of government are subjected to constitutional checks and balances, IPAB is structured to be virtually exempt from such oversight. Instead, IPAB’s proposals could take effect automatically and could even override current Medicare law. Additionally, proposals are likely to restrict patients’ access to needed health care services and treatments by disproportionately targeting new treatments as a way to cut spending – prioritizing cost-cutting ahead of a medicine’s benefits to patients. 

Stakeholders across the health care sector – including hospitals, doctors, patient groups and senior groups – have raised concerns with IPAB. PhRMA recently joined more than 650 organizations in expressing these concerns and requesting repeal of IPAB. The full letter can be found here.  

Additionally, several members of Congress have recently called for the repeal of IPAB, including Senator Wyden, Senator Cornyn and Representatives Roe and Ruiz.