Obama’s Claims IPAB Doesn’t Ration Health Care Don’t Match Reality

National   |   Steven Ertelt   |   Oct 4, 2012   |   12:38PM   |   Washington, DC

During last night’s debate, President Barack Obama tried to rebut an attack from Mitt Romney on Obamacare.

Romney said the controversial health care law contains the Independent Payment Advisory Board, which would ration or limit the kind of health care treatments and services recipients can receive. That’s one reason, apart form abortion funding, that pro-life groups have been strenuously opposed to the Obamacare legislation and favor its repeal.

“We didn’t put in place a board that can tell people ultimately what treatments they’re going to receive,” Romney said, adding he favors repealing Obamacare.

Obama tried to deflect the criticism by saying, the IPAB doesn’t make rationing decisions. But the Republican National Committee today put out a factsheet indicating Obama is wrong and noting misleading statements he made about the IPAB during the debate. That factsheet appears below:

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THE CLAIM: Obama: “It — When Governor Romney Talks About This Board, For Example, Unelected Board That We’ve Created, What This Is, Is A Group Of Health Care Experts, Doctors, Et Cetera, To Figure Out, How Can We Reduce The Cost Of Care In The System Overall?” (President Barack Obama, Presidential Debate, Denver, CO, 10/3/12)

THE FACTS: ObamaCare Created IPAB “To Cut Medicare.” “That’s the job description for the 15 members of the Independent Payment Advisory Board — the new panel created by President Barack Obama’s health care law to come up with ways to cut Medicare spending if it grows too fast.” (David Nather, “Medicare Cost-Cutting Job Could Be Worst In D.C.,” Politico, 5/14/11)

  • The Nonpartisan Congressional Budget Office Found That IPAB Will Be Required To Recommend Changes To Medicare Spending. “The legislation also would establish an Independent Payment Advisory Board, which would be required, under certain circumstances, to recommend changes to the Medicare program to limit the rate of growth in that program’s spending.” (Congressional Budget Office, Letter To Majority Leader Harry Reid , 12/19/09)
  • IPAB Will Advocate For Medicare Payment Cuts To Doctors. “The 15-member board will recommend cuts in Medicare payments to doctors, which will take effect automatically unless Congress votes to block them.” (Sam Baker, “Sebelius: Congress Can Avoid IPAB By Addressing Medicare Costs,” The Hill ‘s Health Watch , 7/12/11)

THE CLAIM: Obama: “Let Me Just Point Out First Of All This Board That We’re Talking About Can’t Make Decisions About What Treatments Are Given. That’s Explicitly Prohibited In The Law.” (President Barack Obama, Presidential Debate, Denver, CO, 10/3/12)

THE FACTS: Medicare Payment Cuts “Could Jeopardize Medicare Beneficiaries’ Access To Mainstream Medical Care.” “…it is equally hard to imagine cutting only Medicare spending while spending by the commercially insured under age sixty-five continues to grow at historic rates, which would lead to a marked divergence between what providers are paid for treating the commercially insured relative to what they are paid for Medicare beneficiaries. This gap could jeopardize Medicare beneficiaries’ access to mainstream medical care.” (Newhouse, Joseph P. (July 22, 2010) “Assessing Health Reform’s Impact on Four Key Groups of Americans,” Health Affairs 29:9, pp. 1-11)

  • Obama’s HHS Secretary Then Admitted That IPAB Recommendations To Cut Dialysis Payments Would Threaten Seniors’ Access To Necessary Treatment. SEBELIUS: “‘If Congress accepted the recommendations and made the decision that cuts in dialysis were appropriate, I assume there could be some providers who would decide that would not be a service they would any longer deliver…” (Committee On Energy And Commerce, U.S. House Of Representatives, Hearing, 7/13/11)

IPAB’s “End Game” Will Limit Patient Care. “The only alternative, and the IPAB’s true end game, is harsher and more arbitrary price controls and eventually limits on the care patients are allowed to receive. The New England Journalists (of Medicine) deny this reality because ObamaCare has a clause that prohibits ‘rationing,’ even as the law leaves that term undefined. But reducing treatment options will be inevitable as government costs explode.” (Editorial, “Independent Payment Advisory Revolt,” The Wall Street Journal, 3/9/12)

  • Witnesses At A Congressional IPAB Argued That IPAB Would Reduce Access To Medical Care. “The Independent Payment Advisory Board, created under the health care law to help control Medicare costs, lacks flexibility to do much more than cut provider payments that would lead to a reduction in access to care, witnesses told a House Ways and Means panel March 6.” (Ralph Lindeman, “IPAB Would Reduce Access to Care, Witnesses Tell Ways and Means Panel,” Bloomberg, 3/7/12)
  • IPAB Will Allow Bureaucrats To “Throw Granny Over The Cliff.” “One place to start is by attacking the Democratic plan to cut Medicare via political rationing. Mr. Ryan’s budget had the virtue of embarrassing President Obama’s spend-more initial budget, and the White House responded by proposing to increase the power of the new Independent Payment Advisory Board (IPAB) to decide what, and how much, Medicare will pay for. The ObamaCare bill goes to great lengths to shelter this 15-member, unelected board from Congressional review, with the goal of letting these bureaucrats throw granny over the cliff if Medicare isn’t reformed . Yet few Americans know anything about IPAB or its rationing intentions.” (Editorial, “The GOP’s New York Spanking,” The Wall Street Journal , 5/26/11)

THE CLAIM: Obama: “Now, So What This Board Does Is Basically Identifies Best Practices And Says, Let’s Use The Purchasing Power Of Medicare And Medicaid To Help To Institutionalize All These Good Things That We Do.” (President Barack Obama, Presidential Debate, Denver, CO, 10/3/12)

THE FACTS: Medicare Actuary Richard Foster On ObamaCare’s Medicare Cuts: “It’s Pretty Hard To Imagine That They Could Be Sustainable.” FOSTER: “And the figures you quoted were correct. And that assumes that again, the private health insurance can’t do something comparable to these mandated reductions in growth rates that are part of current law now for Medicare. In looking at those, it’s pretty hard to imagine that they could be sustainable, because when you think about it, the providers have to pay certain input cost increases. They have to pay somewhat more next year than they do this year. They have to pay higher energy costs. They have medical supplies. They have rent or leases that go up.” ( Testimony Before The House Committee On The Budget, U.S. House Of Representatives,, 7/13/11)

CBO: Obama’s Medicare Payment Cuts To Physicians And Providers May “Be Difficult To Sustain” Over The Long Term. “For Medicare, CBO assumed that three policies that would restrain cost growth might be difficult to sustain over a long period—ongoing reductions in payment updates for most providers in the fee-for-service program, the sustainable growth rate mechanism for payment rates for physicians, and the IPAB—would not continue.” (“The Long-Term Budget Outlook,” Congressional Budget Office, June 2012, p. 57)

  • Centers For Medicare & Medicaid Services: ObamaCare’s Physician Fee Reductions Are “Clearly Unworkable” And Barring Changes, Payment Rates “Would Become Inadequate In The Long Range.” “The immediate physician fee reductions required under current law are clearly unworkable and are almost certain to be overridden by Congress. The productivity adjustments will affect other Medicare price levels much more gradually, but a strong likelihood exists that, without very substantial and transformational changes in health care practices, payment rates would become inadequate in the long range. As a result, actual Medicare expenditures are likely to exceed the projections shown in the 2012 Trustees Report for current law, possibly by considerable amounts.” (John D. Shatto and M. Kent Clemens, “Projected Medicare Expenditures Under Illustrative Scenarios With Alternative Payment Updates To Medicare Providers,” CMS , 5/18/12)