• Remember this the next time they demand Medicare cuts

    From Sam Baker:

    House Republicans signaled Thursday they will not follow rules in President Obama’s healthcare law that were designed to speed Medicare cuts through Congress.

    The House is set to vote Thursday afternoon on rules for the 113th Congress. The rules package says the House won’t comply with fast-track procedures for the Independent Payment Advisory Board (IPAB) — a controversial cost-cutting board Republicans have long resisted.

    The rules package signals that Republicans might not bring up Medicare cuts recommended by the IPAB — blocking part of a politically controversial law, and resisting Medicare spending cuts.

    Remember how the ACA works. If Medicare spending rises too quickly, the IPAB makes recommendations on how to cut spending. If Congress doesn’t agree to those recommendations, they have to vote to override them, and propose cuts of their own. If they don’t, the spending cuts go into effect.

    The Republicans are now saying that they will not abide by those procedures. They will refuse to enact the cuts the IPAB makes. I don’t know if that’s legal or not; someone with more legal knowledge will have to tell me.

    But I hope you will all remember this the next time they demand that someone cut Medicare spending. Someone is trying to.


    • Republicans are trying to cut Medicare spending, too, and have passed bills to that effect. Just not by methods you support. It’s a different ideological belief, not right or wrong. No need to get all partisan and snarky.

      • Ah, but it’s a somewhat constant refrain that Democrats (Obama) won’t cut Medicare. This is a clear example of a way to cut Medicare. If Republicans want to complain that Democrats won’t cut Medicare in a way they like, that’s fine. The complaint is that “they won’t cut spending”. Full stop. I don’t see as many Democrats complaining that Republicans won’t cut spending.

        I, of course, may do that. But that’s because I actually want to cut health care spending…

        • “Ah, but it’s a somewhat constant refrain that Democrats (Obama) won’t cut Medicare.”

          It was also a constant refrain that he would cut Medicare during the presidential race. I think they just have trouble keeping their story straight.

    • Republicans have become big defenders of fat in Medicare. They only want to cut its muscle.

    • off topic, but this just landed in my email:
      Fiscal Deal Kills New Funding for Health Co-ops

      hadnt seen that in all the other coverage i’ve seen…

    • This is not quite right. As I wrote in my paper on IPAB, “The board’s recommendations will go into effect automatically unless Congress passes, and the President signs, legislation to modify or overturn them. Congress may consider, on a fast-track basis, an alternative proposal that achieves the same amount of savings; if the alternative proposal achieves a smaller amount of savings, approval requires a three-fifths vote of the Senate.” The ACA also provides that the Secretary of HHS will issue a report with recommendations if IPAB fails to do so, for example, if the Senate hasn’t confirmed any members. Thus, the change in the House rules won’t prevent IPAB’s recommendations from going into effect. Moreover, the Senate will still be bound by the requirement that alternative legislation must meet the savings target. (See http://www.cbpp.org/cms/index.cfm?fa=view&id=3702.)

    • Health Affairs has a great primer on the Independent Payment Advisory Board (IPAB), how it works and what it is designed to do.