Republicans in both the Senate and the House have introduced bills that would eliminate the new Independent Payment Advisory Board, which is supposed to come up with ways to rein in excessive Medicare spending — and stiffen Congress’s spine.
Starting in 2014, whenever Medicare’s projected spending exceeds a target growth rate, the board of 15 members (drawn from a range of backgrounds, appointed by the president and confirmed by the Senate) will have to recommend reductions in payments to doctors and health care providers to bring spending back to target levels. These recommendations would become law unless Congress — not known for its political courage in such circumstances — passed an alternative proposal that would achieve comparable savings.
None of this poses any real threat to Medicare beneficiaries. The law prohibits the board from making proposals that would ration care, increase taxes, change Medicare benefits or eligibility, increase premiums or cost-sharing, or reduce low-income subsidies for drug coverage. It cannot call for a reduction in payments to hospitals before 2020.
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