Many consider the IPAB
to be the cornerstone of the ACA's goal to slow health care spending in the country.
Unless both Houses of Congress overrule IPAB
by passing their own equal or greater cuts to Medicare, IPAB
's proposals automatically become law.
Under the ACA, the IPAB
is charged with looking at 5-year Medicare spending trends and recommending cuts for the following year if per capita spending exceeds a set target.
In its defense, Obama administration attorneys have argued that IPAB
is sufficiently constrained because the act explicitly bars it from rationing care, increasing deductibles or copayments, or restricting benefits or eligibility.
In an effort to lower the ever-increasing cost of health care, the ACA created the IPAB
based upon an idea that was floated back in 1999 by the National Bipartisan Commission on the Future of Medicare.
The American Association of Clinical Urologists (AACU), the American Urological Association (AUA), and the Large Urology Group Practice Association (LUGPA) issued a joint statement, noting, "we are concerned that there are key aspects to this law that will, ultimately, hurt this nation's ability to provide widespread care for its citizens," including the IPAB
It now appears that the CBO believes IPAB
will have no budgetary impact.
It is not an overstatement to say that the long-term viability of social insurance in America depends on whether IPAB
is able to successfully manage Medicare pricing.
If a board like IPAB
had produced good empirical evidence that any of these treatments were ineffective, I would have been the first to say, Please don't give me this treatment.
is an independent board of experts that would recommend strategies for preventing excess spending growth in Medicare (Aaron, 2011).
The direct strategies include the so-called Cadillac Tax on high-cost health insurance plans and the Independent Payment Advisory Board or IPAB
, which is a board that can impose direct changes in reimbursement if Medicare spending exceeds specified rates of increase.
Several health care stakeholders are critical of the IPAB
provision because the commission's recommendations take effect unless Congress overturns their ruling.