Its members haven't been selected, and it doesn't even come into existence for more than a year, but already the oversight panel for Medicare that was created by President Obama's health care reform law is reigniting the fiery debates that preceded the law's passage more than a year ago.
When it springs to life in 2013, the Independent Payment Advisory Board, or IPAB, will field 15 members, all appointed by the president, subject to Senate confirmation. Their mission: to bend the cost curve -- i.e., slow the pace of growth -- for Medicare with recommendations that will carry the force of law -- unless Congress passes its own laws to override them.
On Jan. 15, 2014, IPAB will submit to Congress its first set of recommendations, with more to come on the same date in each of the next four years. Congress can act at any time to adopt those recommendations or pass more stringent laws to achieve the same or more effective ends, where costs are concerned. If that happens, IPAB's recommendations would remain on the shelf. But if Congress does not act within one year of its receipt of a given set of IPAB proposals, then those proposals become law.
During those first four years, IPAB's members will monitor medical data and the Consumer Price Index for signs of inflation in Medicare costs. Then, starting in 2018, the panel will peg its assessments about cost increases to the American economy, with IPAB's recommendations set to take effect if, in that year, the average cost of Medicare for each beneficiary exceeds the country's gross domestic product (GDP) by 1 percent -- and Congress hasn't acted.
The Congressional Budget Office has projected that growth in Medicare costs will not reach that point until a decade from now.
Still, as part of his broader effort to tackle America's looming debt crisis, Obama proposed last week that Congress modify the law to allow IPAB's recommendations to take effect sooner -- namely, if average Medicare costs rise by merely 0.5 percent of GDP. The Congressional Budget Office has not weighed in on how soon it sees that happening.
Critics contend IPAB will, over time, serve to ration health care
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