News | July 26th, 2017

Deadline to Kill the Death Panel

Health policy experts Grace-Marie Turner and Doug Badger have an op-ed published in The Wall Street Journal noting that Congress has the opportunity before August 15 to pass a bipartisan resolution that would bring an end to the Independent Payment Advisory Board, an entity that threatens health access for millions of Medicare beneficiaries.  The text of the op-ed is as follows:

All eyes are on the Senate as it debates what to do about ObamaCare. But the House has a last chance this week to abolish one of the law’s most dangerous creations: a board with sweeping, unchecked power to ration care.

The Independent Payment Advisory Board—what critics call the death panel—would be an unelected, unaccountable body with broad powers to slash Medicare spending. But the law contains a living will for IPAB. If the president signs a congressional resolution extinguishing the panel by Aug. 15, it will never come into existence.

The real deadline is closer, since the House plans to recess Friday and not return until Sept. 5. But if the House does act, the Senate will have time to follow, since it plans to remain in session until mid-August.

 The IPAB’s powers would be vast. If government actuaries find that Medicare spending would exceed caps established by ObamaCare, the board is required to write a plan to stay under the caps. Congress can pass its own bill to reach the target if it acts promptly—but if not, the secretary of Health and Human Services must implement IPAB’s plan, which would be exempt from judicial review.

 

Medicare spending has so far not exceeded the IPAB trigger, but eventually it will. Although the statute expressly forbids IPAB from “rationing,” that is scant comfort. Government-run health systems typically ration care by cutting payments to doctors and hospitals, something IPAB has the authority do.

Medicare’s trustees warn in their new annual report that “access to physicians treating Medicare patients may become a significant issue in the long term.” In the same report they predict that “approximately half of hospitals, 70 percent of skilled nursing facilities, and over 80 percent of home health agencies” would be losing money by 2040 under IPAB-enforced spending caps, “raising the possibility of access and quality-of-care issues for Medicare beneficiaries.”

The IPAB repeal provision has a catch: Passage of the resolution requires a three-fifths vote in the House and Senate. House leaders would need 261 votes (there are 240 Republicans), a tall order. But not all Democrats supported IPAB when ObamaCare was enacted. If an unelected panel is calling the shots, asked then-Rep. Pete Stark, a liberal Democrat, “why have legislators?”

The resolution against IPAB would be unamendable and immune to filibuster—meaning it would have a much easier time in the Senate than would ordinary legislation to abolish IPAB.

The outcome of this week’s Senate debate on ObamaCare will likely disappoint many of the law’s opponents. But repealing the ObamaCare “death panel” would give Congress a much-needed accomplishment and give legislators breathing room to reform Medicare the right way. The pathway will get much harder unless the House acts before leaving town on Friday.

Ms. Turner is president, and Mr. Badger a senior fellow, at the Galen Institute.