Republicans had an easy time getting H.R. 452, the Medicare Decisions Accountability Act bill, through a House Energy & Commerce Committee health subcommittee markup Wednesday.
Subcommittee members voted 17-5 to approve the Medicare payment bill.
All Republicans on the subcommittee voted for the bill.
Only 5 of the 11 Democrats on the subcommittee voted against the bill.
Rep. Frank Pallone Jr., D-N.J., and Rep. Edolphus Towns, D-N.Y., crossed party lines to side with the Republicans and vote for the bill.
If passed and implemented as written, the bill would eliminate the Independent Payment Advisory Board (IPAB), a 15-member body created by sections 3403 and 10320 of the Patient Protection and Affordable Care Act of 2010 (PPACA).
IPAB members must be nominated by the president and confirmed by the Senate. But PPACA drafters tried to give IPAB enough independence to make unpopular decisions about Medicare reimbursement rate cuts by allowing the body to make reimbursement rate decisions free from judicial review.
The IPAB members would be paid $165,300 per year and serve 6-year terms, according to Rep. Joseph Pitts, R-Pa., the subcommittee chairman.
If Medicare's annual per-capita spending is found to exceed a specified limit, IPAB would have to give Congress a proposal for reducing Medicare spending growth. The proposal would take effect automatically unless Congress passes legislation that achieves the same amount of savings.
"Supporters of IPAB tell us that there is nothing wrong with having 15, unelected bureaucrats making binding decisions about Medicare policy," Pitts said at the markup. "They are not troubled by the fact that there is no requirement for public comment prior to IPAB issuing its recommendations. That IPAB’s actions are not subject to judicial review does not alarm them."
Rep. Henry Waxman, the highest-ranking Democrat on the Energy & Commerce Committee, said the Republicans are mounting another political attack on PPACA.
"For the last year, House Republicans have been claiming – erroneously – that we cannot afford to maintain Medicare’s promise to seniors," Waxman said. "Yet today, they will vote to repeal provisions in the Affordable Care Act that will save Medicare over $2 billion."
Waxman says the Republicans have identified no way to pay for the cost of eliminating IPAB.
"Their logic makes no sense: they say we can’t afford Medicare, yet they want to eliminate one of the innovations in the Affordable Care Act that keeps Medicare costs under control," Waxman says. "It is this kind of political opportunism that is alienating so many Americans from Congress."