Protecting Seniors’ Access to Medicare Act - H.R. 849

The House passed H.R. 849 (307-111), which would repeal the provisions of the Affordable Care Act (ACA) that established the Independent Payment Advisory Board (IPAB) and that created a process by which the Board (or the Secretary of the Department of Health and Human Services) would be required under certain circumstances to modify the Medicare program to achieve specified savings. 

Summary

H.R. 849 would repeal the provisions of the Affordable Care Act (ACA) that established the Independent Payment Advisory Board (IPAB) and that created a process by which the Board (or the Secretary of the Department of Health and Human Services) would be required under certain circumstances to modify the Medicare program to achieve specified savings.

Background

The IPAB, or Dealth Panel as it has come to be known, is tasked with coming up with Medicare cuts if spending rises above a certain threshold. It has drown critisism from both political parties. Nobody has been appointed to the panel and budget experts have estimated they don’t expect IPAB to be triggered until 2021 or 2022. Democrats say Congress has the authority to overrule any recommendations the panel could make. The bill has bipartisan co-sponsors, but Democrats said during the bill’s committee markup that they wished Republicans were focusing on other priorities. 76 Democrats backed abolishing the board despite the objections of leadership. The panel’s proponents say the board is necessary to address Medicare’s runaway spending and keep the program fiscally solvent for future enrollees.

Cost

The Congressional Budget Office (CBO) estimates that enacting H.R. 849 would increase direct spending by $17.5 billion over the 2018-2027 period. That estimate is extremely uncertain because it is not clear whether the mechanism for spending reductions under the IPAB authority will be invoked under current law for most of the next ten years. Under CBO’s current baseline projections such authority is projected to be invoked in 2023, 2025, and 2027. However, given the uncertainty that surrounds those projections, it is possible that such authority would be invoked in other years. Taking into account that possibility, CBO estimates that repealing the IPAB provision of the ACA would probably result in higher spending for the Medicare program over the 2022 through 2027 period than would occur under current law. CBO’s estimate represents the expected value of a broad range of possible effects from repealing IPAB provisions.