UtilityIndependent Payment Advisory Board

What is the Independent Payment Advisory Board?

The Independent Payment Advisory Board (IPAB) was created as a part of the Affordable Care Act (ACA) in 2010 and is charged with proposing cuts to Medicare if spending exceeds a certain growth target. To date, no members have been appointed to the 15-person board. According to the Medicare Trustees, IPAB is likely to be triggered for the first time in 2017, though if a board is not in place, the Secretary of Health and Human Services (HHS) would be required to put forth recommendations.

All proposed cuts from IPAB (or the Secretary) would be mandatory and any changes to Medicare would not require Congressional approval. This largely unchecked power puts patients at risk and could negatively impact patient care by limiting access to some medicines and treatments. 

Update: On February 9, 2018, President Trump signed legislation into law that included the repeal of the Independent Payment Advisory Board.

How does IPAB put patients at risk?

Cuts proposed by IPAB would be mandatory and largely unchecked, giving the board – or the Secretary of Health and Human Services  the power to make widespread changes to Medicare without congressional approval. While other branches of government are subjected to constitutional checks and balances, IPAB is structured to be virtually exempt from such oversight. Instead, IPAB’s proposals could take effect automatically and could even override current Medicare law. Additionally, proposals are likely to restrict patients’ access to needed health care services and treatments by disproportionately targeting new treatments as a way to cut spending – prioritizing cost-cutting ahead of a medicine’s benefits to patients. 

There is broad, bipartisan opposition to IPAB. More than 670 organizations across the health care system have voiced concerns, including hospitals, doctors, patient groups and senior groups, and members of Congress from both parties support repeal. IPAB and blunt cuts to programs that provide care are the wrong approach to reforming our health care system to deliver better value for patients. Instead, we should address health care costs holistically to build a sustainable, science-based system that stems the growth of chronic disease and continues delivering innovative treatments to patients.