There's a chance that IPAB won't kick into gear for a while. The Congressional Budget Office estimated in 2011 that, based on Medicare spending trends, it could be a decade before any IPAB action is needed.
What happens next?
Republicans in the House effectively framed the IPAB debate as their effort to defend seniors from a rationing board. They may have a good campaign issue to appeal to Medicare beneficiaries. Although the Senate is unlikely to take any IPAB action, the issue will be top of mind for senior voters.
Still, the Department of Health and Human Services has proven itself adept at implementing the ACA despite its critics. Look for HHS to continue to press for IPAB.