It has been months since I added anything new to the health care reform primer. I covered virtually all of the insurance-related provisions last year, and the remainder of the Patient Protection and Affordable Care Act, while still important, is less relevant to IIABNY members. However, one of my original reasons for doing this series of posts was to combat the spread of misinformation about the law. I still feel that, while reasonable people may support it or despise it, they should take those positions based on what is actually in the law's text, not on what talk radio or letters to the editor say.
One provision that has been the source of frequent criticism is the creation of an Independent Payment Advisory Board (IPAB). The IPAB has been referred to as "the real death panel, the true seat of rationing, and the royal road to health-care socialism." Others have called it "the most promising cost control in the Affordable Care Act..." The rapid rise of health care costs is one of the problems the PPACA is supposed to address. So, is the IPAB part of the solution, or is it the first slide down the slippery slope of health care rationing?
In this series of blog posts, I will summarize what the law says and leave it to you to decide whether this is good or bad. I expect that readers will differ on their conclusions, but at least you will know what the facts (as reflected in the law's text) are. For reference, all provisions relating to IPAB are in Title 42 of the United States Code, Section 1395kkk.
What is the IPAB?
The IPAB is an independent board within the federal government charged with developing and submitting proposals containing recommendations to reduce the growth rate in per capita Medicare costs in any year in which the projected growth rate exceeds a target rate. (see subsection (b))
Who will sit on the IPAB?
The IPAB will have 15 members, nominated by the president and subject to confirmation by the Senate. The secretary of Health and Human Services, the administrator of the Center for Medicare & Medicaid Services, and the adminstrator of the Health Resources and Services Administration will be non-voting members. The members must have national recognition for their expertise in:
- Health finance and economics
- Actuarial science
- Health facility management
- Health plans and integrated delivery systems
- Reimbursement of health facilities
Other qualified individuals include allopathic and osteopathic physicians, other health service providers, those in related fields, "who provide a mix of different professionals, broad geographic representation, and a balance between urban and rural representatives." Health service providers cannot make up the majority of the board members.
Members will serve six-year terms and may serve up to two consecutive full terms. The chair of the board is also subject to confirmation by the Senate. (All of this is in subsection (g))
What power does the IPAB actually have? That's the subject of tomorrow's post.