Understanding the Independent Payment Advisory Board or IPAB

TUnderstanding the IPABhe Patient Protection and Affordable Care Act, along with modifications made by the Healthcare Education Affordability Reconciliation Act (collectively, the "Healthcare Reform Law") was signed into law on March 23, 2010. One of the more controversial provisions of this legislation was establishing the Independent Payment Advisory Board or IPAB.

IPAB Specifics

  • Who is on this Committee? Congress and the President will appoint 15 independent and diverse experts to serve on the board. Including doctors, consumers and patient advocates

  • The Purpose: To reduce health care spending when Medicare spending exceeds certain threshold levels.

  • IPAB’s Power? They have the ability to change Medicare payment policy, and the controversial aspect of it, is that they need little to no Congressional input to make changes.

Recommendations made by the Board are not binding until after 2015, but experts conclude that the ability to overturn recommendations by the board is highly unlikely, causing concern. The reasons? The recommendations by the IPAB board on Medicare spending are binding, unless:
1. A majority in Congress votes to overturn the policy


2. Votes in favor of changes in Medicare spending that would produce savings equal to the amount identified by the Board.

Reasons for the Support of the IPAB Board

Supporters for the IPAB board have conveyed one main reason for their support:

  • Congress is too persuadable in regards to public pressure, especially when it comes to making tough decisions about Medicare spending.

IPAB’s Current Progress:

  • The GOP majority in the House of Representatives has made it a priority to get the IPAB board repealed.

  • A number of prominent House Democrats have joined the GOPs in their efforts to repeal the IPAB board.  

  • On February 29th, the House Energy and Commerce Health Subcommittee voted 17 - 5 to abolish the IPAB board.  

  • It is unknown however, how likely it is that this legislation will be abolished by the Senate.  Some of the strongest supporters of the IPAB board are in the Senate. Additionally, if Congress repeals the IPAB board, a Presidential veto could be expected.

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