Fix Health Care Policy

Not all surprises are good. When it comes to Obamacare, the original projections are turning into unfortunately different realities. For the next three days, Heritage is going to highlight one of the various changes in Obamacare projections (e.g., cost, enrollment, etc.) from when the law first passed until now.

Obamacare created the Independent Payment Advisory Board (IPAB), which consists of 15 unelected bureaucrats who are tasked with finding savings within Medicare to meet a new, fixed target for spending growth in the program. The board’s recommendations will be implemented unless Congress enacts an alternative proposal that amounts to the same level of savings.

In 2010, the Congressional Budget Office (CBO) projected that IPAB would result in Medicare savings of $15.5 billion from 2010–2019.

In 2012, the CBO projected that the IPAB would result in zero savings for the years 2015–2019.  According to the CBO, “…the IPAB mechanism will not affect Medicare spending during the 2011-2022 period.” Later, in a letter regarding the repeal of Obamacare, CBO estimated that the IPAB could save $3.1 billion over the 2013–2022 period, but cautioned “That estimate is extremely uncertain because it is not clear whether the mechanism for spending reductions under the IPAB authority will be triggered under current law over the next 10 years.”

Surprise: The IPAB is yet another Obamacare plan that not only sounds like a bad idea, it is a bad idea. The IPAB is like a fruit cake—and it’s time to regift.

12 Days of Obamacare Surprises:

9. Increased employer penalties…

8. More cuts to Medicare…

7. Loss of employer-sponsored insurance…

6. A 50/50 split on enrollment estimates…

5. More uninsured Americans…

4. Increased exchange subsidies…

3. Big tax increases…

2. The small business tax credit…

1. And the individual mandate.

Tags: cost control, Independent Payment Advisory Board, IPAB, Medicare, Obamacare surprise

The Supreme Court’s Obamacare decision is expected next week, but it’s important to remember that the constitutionality of the law’s individual mandate isn’t the only concern. Several surveys have revealed that doctors have a negative view of the law and its impact on the practice of medicine. Here are five ways Obamacare will harm doctors:

1. Adds more patients to Medicaid. Beginning in 2014, Obamacare dumps an additional 19.6 million Americans into Medicaid. On average, Medicaid physician payments are only 56 percent of what private insurance pays. Lower payment rates already discourage doctors from accepting Medicaid beneficiaries, which has lead to access issues and hospital emergency room overcrowding. As more patients enroll in this broken program, it will place even more financial strain on physicians who treat them. Doctors will be faced with the decision to either discontinue treating Medicaid patients or accept even more patients at the lower payment rate.

(Read the rest on The Foundry…)

Tags: doctor-patient relationship, doctors, harmful, IPAB, Medicaid Expansion, Medicare cuts, ObamaCare

In anticipation of the Supreme Court’s Obamacare decision, it is important to remember that the constitutionality of the individual mandate isn’t the only problem with the law. Here’s a list of Obamacare’s five most destructive impacts on America’s seniors.

1. Less choice. Obamacare puts 15 unelected bureaucrats in charge of meeting a budget target in Medicare with its newly created Independent Payment Advisory Board (IPAB). IPAB may be statutorily prohibited from directly rationing care, but that doesn’t mean it can’t ration indirectly by reducing provider payments for certain medical procedures, which can compromise physician autonomy in the delivery of care. In fact, the only way IPAB can control costs is by reducing provider payments. But cutting payments effectively rations care by limiting Medicare beneficiaries’ access to providers.
2. Fewer options. Obamacare delivers a strong blow to Medicare Advantage (MA), which allows seniors to receive Medicare benefits from a private health plan of their choosing. MA is popular among seniors—about 25 percent of beneficiaries are in the program—and in 2012, premiums fell by 7 percent and enrollment increased by 10 percent. But Obamacare cuts the program by $145 billion, which, according to the Medicare Actuary, will decrease enrollment by 50 percent by 2017. Furthermore, Heritage research shows that after Obamacare is fully implemented, MA beneficiaries will lose an average of $3,714 worth of benefits per year by 2017.

See the rest on The Foundry…

Tags: fewer options, IPAB, Medicare, ObamaCare, physician access

Earlier this week, the House Energy and Commerce Health Subcommittee moved legislation forward that would repeal one of the most intrusive and unpopular parts of Obamacare: the Independent Payment Advisory Board (IPAB). A board of unelected government officials tasked with finding and implementing ways to control Medicare spending from the top-down, IPAB opens the door to rationing of care, both direct and indirect, without congressional approval.

The bill to repeal this onerous part of the health law has 226 co-sponsors, 17 of whom are Democrats. Meanwhile, support for better ways to control Medicare’s cost using a premium support model continues to surface on both sides of the aisle. Premium support would allow seniors to use a defined government contribution to purchase the private plan that suits them best in a competitive marketplace. Patient empowerment and choice would drive better value for dollars spent, bringing down costs without jeopardizing quality or patient autonomy through government rationing.  (Read the rest on The Foundry…)

Tags: IPAB, Medicare, ObamaCare, rationing, Seniors, top-down decisions

Tomorrow, the Energy and Commerce Committee will mark up legislation to repeal Obamacare’s Independent Payment Advisory Board (IPAB). IPAB is a dangerous mechanism that puts the power to limit seniors’ treatment options and access to care in the hands of unelected bureaucrats, essentially ending Medicare as we know it.

Despite the enormity of IPAB’s power and its influence on Medicare beneficiaries, its members are not accountable to the American people, unlike Congress. IPAB will consist of 15 unelected bureaucrats who are tasked with finding savings within Medicare to meet a new, fixed target for spending growth in the program. IPAB members will be appointed by the President and approved by the Senate, and the board’s recommendations will be implemented by the Secretary of the Department of Health and Human Services (HHS) unless Congress enacts an alternative proposal that amounts to the same level of savings.  (Read the rest on The Foundry…)

Tags: bureaucrats, cost control, Energy and Commerce Committee, IPAB, Medicare, rationing care

This week, the House Budget Committee and Energy and Commerce Committee held hearings to examine the Independent Payment Advisory Board (IPAB), a board of unelected bureaucrats tasked under Obamacare to reduce the growth in Medicare spending.

During the Budget Committee hearing, Grace-Marie Turner, president of the Galen Institute, described the board:

[T]he IPAB is unprecedented in the power given to unelected officials to direct hundreds of billions of dollars in federal spending. The IPAB will give unelected, unaccountable government appointees the power to make decisions about payment policy in Medicare that will ultimately determine whether millions of seniors have access to the care they need. This challenges the very principles of representative democracy and consent of the governed.   (Read the rest at The Foundry…)

Tags: Energy and Commerce Committee, House Budget Committee, IPAB, Medicare spending, unelected bureaucrats

This morning, the House Budget Committee invited Health and Human Services Secretary Kathleen Sebelius to a hearing on the Independent Payment Advisory Board (IPAB), the left’s weapon of choice for tackling Medicare’s $38 trillion in unfunded promises to America’s seniors.

Both sides of the debate agree that extensive reductions to Medicare’s runaway spending are needed, and have even proposed comparable targets for growth in spending. The key difference, then lies in who makes the difficult decisions regarding seniors’ health care under the chosen direction for reform: Patients, or bureaucrats?  (Read the rest on The Foundry…)

Tags: consumer-driven health care, HHS Sec. Kathleen Sebelius, IPAB, Medicare, ObamaCare, Rep. Paul Ryan, runaway spending

The hot Washington Medicare debate centers on whether congressional Republicans will, in the language of the left, “End Medicare As We Know It.” But the dirty little secret on Capitol Hill is that Obamacare already ended the program as we know it.

They don’t tell you that in those clever “Mediscare” ads.

Here’s what Obamacare has already done:

• Replaced Medicare’s traditional financing. Obamacare replaces Medicare’s fee-for-service structure—the very heart of traditional Medicare financing—with capitated payments and salaried physicians. Whether this is a good or bad idea, it’s not your grandpa’s Medicare.

• Capped future Medicare spending. While slashing roughly a half-trillion dollars in Medicare provider payments over the next 10 years, congressional liberals imposed a hard cap on future Medicare spending. Once again, good or bad idea, it’s the law right now: No open-ended Medicare entitlement.

• Put an unelected board in charge. Then congressional liberals went even further: They created the Independent Payment Advisory Board (IPAB), a group of 15 unelected bureaucrats, to cut payments to Medicare providers. In fact, unless Congress enacts an alternative plan to cut Medicare spending by the pre-ordained amount, the Secretary of Health and Human Services is authorized to enforce the board’s recommended cuts without congressional approval.  (Read the rest on The Foundry…)

Tags: IPAB, Medicare spending, physician payments, rationing board