Q. I’ve been reading that both Democrats and Republicans want to eliminate the Affordable Care Act’s Independent Payment Advisory Board (IPAB), the panel that is supposed to curb Medicare inflation. The critics say that they don’t want unelected bureaucrats rationing health care. Are they right?
A. The members of the IPAB board will be unelected, but they are not unaccountable. Board members will be appointed by the President, but they must be confirmed by the Senate. The President is required to consult with Congressional leadership in making 12 of the 15 appointments.
Board members will not be bean-counting bureaucrats. They must possess expertise in health care, economics, research and technology assessment. Up to half may be health care providers.
IPAB’s recommendations will be open to public comment: A Consumer Advisory Council, composed of 10 members appointed by the Comptroller General will advise IPAB on the impact of payment policies on consumers.
Finally, and most importantly, IPAB is a backstop. It won’t be used unless other initiatives in the ACA don’t work to rein in spiraling Medicare spending. Right now, that spending is slowing.