Winners and Losers in the Great IPAB Debate

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

Loser: Bipartisanship
The original effort to repeal the section of PPACA that creates IPAB had 232 co-sponsors, including 17 Democrats. Much was made of this wonderful bipartisan effort until House Republicans unexpectedly decided to link medical malpractice and IPAB into a single bill. That caused problems for Democrats, who typically oppose tort reform. In the final vote, only seven Democrats actually supported the combined bill. Political pundits have suggested that Republicans never really wanted Democrats to vote with them because they see IPAB as an important GOP campaign issue that would be muddied by Democratic support.

Loser: Rep. Allyson Schwartz (D-PA)
Rep. Schwartz is a Democrat from a relatively safe district in Pennsylvania. She supported PPACA but was one of the first Democrats to support the elimination of IPAB from the bill. She has been very vocal in her support for the Republican position, speaking against IPAB in various House committee meetings, and even penning an opposition op-ed for USA Today.

Still, she has her limits. When House Republicans added med-mal to the IPAB bill, Rep. Schwartz put her foot down and issued a statement asking them to "set aside political showmanship and bring a clean bill to repeal IPAB to the floor for a vote … Linking this bill to tort reform—an unrelated, divisive, and partisan issue—is bringing what was once a bipartisan effort to a screeching halt. I urge the Rules Committee to reject this offset." That didn't happen, and Schwartz cast her vote against the IPAB repeal.

Winner: The American Medical Association
The AMA scored a twofer, with the House voting its way on medical malpractice as well as IPAB. In a press release touting the vote, the AMA echoed the common complaint that the IPAB panel "would have too little accountability and the power to make indiscriminate cuts that adversely affect access to healthcare for patients." But the AMA still gives PPACA a thumbs up. The group was an early supporter of PPACA, just not for the parts that involve cuts to the physician payment formula.

Winner: 60 Plus Association
Billing itself as the "conservative alternative" to the AARP, 60 Plus earmarked $3.5 million for anti-IPAB media buys in five states where Democratic senators are vulnerable. Pat Boone, the aging crooner and the group's national spokesperson, tied each senator to IPAB—no small feat since the actual repeal vote was in the House—and asked residents to urge the senators to "support real Medicare reform and protect our seniors." The ad will probably help put IPAB in play for the upcoming election season and increases the media profile of the 60 Plus Association.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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