Winners and Losers in the Great IPAB Debate

Margaret Dick Tocknell, for HealthLeaders Media , March 28, 2012

When the Republican Party reclaimed the House majority after the 2010 elections, one of its first acts was to repeal the entire Patient Protection and Affordable Care Act. The bill was sent to Democratic-majority Senate, where it still sits with no action planned.


House Republicans then decided to aim their healthcare reform ire at the Independent Payment Advisory Board (IPAB). Over the course of just a few months, IPAB shifted from a little-known board tucked somewhere away somewhere in the behemoth PPACA to a household word.

Last week, after six hours of debate and two hours of procedural rulings, the House voted, more or less along party lines, to eliminate the IPAB. As with most political issues, there are winners and losers in the great IPAB debate. Here's a look:

Toss-up (but leaning loser): Independent Advisory Payment Board
Although the Senate is not expected to follow House action and vote to eliminate the IPAB, some damage has been done. Yes, IPAB will remain the law of the land, but recruiting 15 members for the board just got a lot more difficult. The original idea was that the great minds of healthcare will come together and, if needed, make the tough financial decisions required to strengthen Medicare. To remain unencumbered by outside influences, board members will be required to forgo research projects, consulting, and the Washington party circuit to devote themselves to the task at hand. Even if PPACA survives the current Supreme Court challenge, it's likely that IPAB will remain a sore point and could be under constant pressure to be eliminated or changed.

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