Groups Call for Repeal of IPAB, Obama Admin’s Death Panels

National   |   Steven Ertelt   |   Mar 19, 2012   |   12:00PM   |   Washington, DC

A coalition of moderate and conservative political groups are putting pressure on Congress to approve legislation that would repeal the Independent Payment Advisory Board, which has been derisively called “death panels” by detractors.

Lawmakers on a House health subcommittee began the process of reversing one of the more contentious parts of Obamacare last month when the Energy and Commerce Health subcommittee voted 17-5 to repeal it — with pro-abortion lawmakers Rep. Frank Pallone of New Jersey and Rep. Edolphus Towns joining with Republicans to vote to end it.

Then, with support from across the political spectrum, the House Energy and Commerce Committee, by a voice vote, approved H.R.452, which would repeal the IPAB.

The legislation also falls under the jurisdiction of the House Rules and the Ways and Means committees, came under criticism from both Republicans and Democrats. As Jennifer Popik, J.D., a pro-life attorney with the National Right to Life Committee, noted, even longtime proponent of single payer healthcare, Pete Stark (D-Ca), railed against the IPAB, saying it is a “provision I strongly oppose.”

Now, a broad coalition of citizen groups have sent a powerful message to Congress with the following letter, which urges the immediate repeal of ObamaCare’s health care rationing board.

Dear Member of Congress:

On behalf of the 26 undersigned members of the Health Care Freedom Coalition and our ally organizations, representing industry, policy, taxpayer, and medical professional groups, and their millions of patients and members, we are writing to express our concerns regarding the Independent Payment Advisory Board provision of the Patient Protection and Affordable Care Act and the disastrous impact of its implementation on both patient care as well as Congressional authority.

Section 3403 of the Patient Protection and Affordable Care Act (PPACA) established the Independent Payment Advisory Board (IPAB) to reduce Medicare spending. But ultimately this panel of 15 independent, unelected bureaucrats with unilateral authority and whose decisions are freed from judicial and administrative review will most certainly cut payments to physicians under Medicare, will limit patient access to, and quality of, medical care.

Independent, Unelected, Politically-Appointed Bureaucrats

Of the 15 members, twelve  will be appointed by the President, and the law actually prevents practicing medical professionals- like doctors – from membership. The rules almost guarantee that the members will be academics. The highly-paid bureaucrats will likely be paid more than many of the doctors they are second-guessing. These six-year terms come with an anticipated paycheck of $165,300 – more than the average family practice physician earns in many cities in Ohio, Pennsylvania and Florida.

Undemocratic, Unilateral Authority and Lack of Redress or Review

The decisions cannot be challenged in the courts and are freed from the normal administrative rules process – require no public notice, public comment or public review.   IPAB “recommendations” carry the full force of the law, unless 2/3 of the House and Senate vote to override.  In essence, Congress has given this Board the authority to legislate.

Decisions Will Impact Physicians & Patients

The board is specifically forbidden from “any recommendations to ration health care”, but PPACA fails to define the word “ration.” Instead, it allows IPAB to pay doctors reimbursement rates below costs, which in essence would constrict a physician’s ability to treat patients. Longitudinal studies already show that about one-fourth of doctors already refuse new Medicare patients, and as many as 50% restrict the services they are willing to perform for their current patients.  And this is expected to worsen, as even more doctors will be unable to afford to take Medicare patients.

Absolves Congress from Oversight & Decision-Making

IPAB is intended to take tough decisions about Medicare spending out of the purview of Congress, in effect, delegating away its legislative responsibilities under the Constitution to either a 15-member Board, or by default, the Secretary of Health and Human Services.  IPAB was simply created to absolve Congress of having to make decisions that directly impact the quality and access of care for Seniors, and also insulate them from having to make tough decisions.

The ill-advised quest for “cost effectiveness” is doomed to failure. As we have seen in Great Britain, any de facto price controls are likely to do nothing to control the growth of spending.  Further, this one-size-fits-all approach to dictating medical care in a country of more than 300 million is ill-advised.

If Congress believes that these decisions handed over to IPAB are too much of a hot political potato for it to decide, then perhaps it is a clear indication that this is the wrong course of action.


Kathryn Serkes, CEO & Chairman, Doctor Patient Medical Association

Grover Norquist, President, Americans for Tax Reform

Dean Clancy, Legislative Counsel & VP, Health Care Policy, FreedomWorks

Jim Martin, Chairman, 60 Plus Association

Heather Higgins, President & CEO, Independent Women’s Voice

Colin A. Hanna, President, Let Freedom Ring

Ken Hoagland, Chairman, Restore America’s Voice Foundation

Christopher M. Jaarda, President, American Healthcare Education Coalition

HSA Coalition

Tim Phillips, President, Americans For Prosperity

Amy Ridenour, Chairman, The National Center for Public Policy Research

Mario H. Lopez, President, Hispanic Leadership Fund

David Williams, President, Taxpayers Protection Alliance

Andrew Langer, President, Institute for Liberty

Jane Orient, MD, Executive Director, Association of American Physicians & Surgeons

Eric Novak, MD, US Health Freedom Coalition

Andrew F. Quinlan, President, Center for Freedom and Prosperity

Grace-Marie Turner, President, Galen Institute

Hal C. Scherz, MD, FACS, FAAP, President & CEO, Docs 4 Patient Care

Amy Kremer, Chairman, Tea Party Express

Penny Nance, CEO and President, Concerned Women for America

Dr. Joseph L. Bridges, President & CEO, The Seniors Coalition

Pete Sepp, Executive Vice President, National Taxpayers Union

Judson Phillips, Tea Party Nation

Stephani Scruggs, President, Unite In Action, Inc

Ana Puig, Co-Founder, Kitchen Table Patriots

Pro-life NRLC attorney Jennifer Popik talks about the pro-life rationale for ending the program.

“Integral to the Obama Administration’s stated mission to drive down what Americans choose to spend for life-saving and health-preserving health care, the IPAB is charged with a key role in suppressing health care spending by limiting what treatment doctors are allowed to give their patients,” she says. “While the focus throughout this debate has been on the IPAB’s  authority to cut Medicare with very limited Congressional authority to override or alter those cuts, National Right to Life has been emphasizing a still graver concern – one at the core of rationing in ObamaCare.”

“The health care law instructs the IPAB to make recommendations to limit what all Americans are legally allowed to spend for their health care to hold it below the rate of medical inflation.  The health care law then empowers the federal Department of Health and Human Services to implement these recommendations by imposing so-called “quality” and “efficiency” measures on health care providers,” Popik continues. “What happens to doctors who violate a “quality” standard by prescribing more lifesaving medical treatment than it permits? They will be disqualified from contracting with any of the health insurance plans that individual Americans, under the Obama Health Care Law, will be mandated to purchase.  Few doctors would be able to remain in practice if subjected to that penalty.”

“This means that treatment a doctor and patient deem advisable to save that patient’s life or preserve or improve the patient’s health–but which exceeds the standard imposed by the government–will be denied even if the patient is willing and able to pay for it. Repeal of IPAB is critically important to prevent this rationing of life-saving medical treatment,” she adds.



Rep. Joe Pitts, a pro-life Pennsylvania Republican, opened the subcommittee hearing meeting, the Hill report indicated, by arguing that the IPAB would make it more difficult to administer Medicare policy, saying, “Supporters of IPAB tell us there is nothing wrong with having 15 unelected bureaucrats making binding decisions about Medicare policy.”

“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,” Pitts said.

He said that, although the law claims the board can’t make decisions that result in rationing, the term is undefined:  “For example,” he asked, “is it rationing if IPAB slashes provider reimbursements to the point that doctors decide they can no longer see Medicare patients?”

National Right to Life called for approval of the bill that would repeal the Independent Payment Advisory Board established by the controversial Obamacare legislation that funds abortions and prompts rationing concerns. The Obamacare measure is also the vehicle for the new mandate the Obama administration put in place that has drawn strong opposition from religious groups concerned that they would have to pay for birth control and drugs that may cause abortions for their members or employees.

“Repeal of the Independent Payment Advisory Board (IPAB) is critical to prevent the rationing of life-saving medical treatment,” said Burke Balch, J.D., director of National Right to Life’s Robert Powell Center for Medical Ethics. “The IPAB would recommend drastic limits for the Department of Health and Human Services to impose on what Americans are allowed to spend out of their own funds to save their own lives and the lives of their families.”

In a letter to members of the Subcommittee on Health, National Right to Life noted that  “[t]he Obama law directs the Board to issue recommendations to limit what ordinary citizens and their health insurance coverage can pay for medical treatment so as to prevent it from keeping up with the rate of medical inflation.”

The letter also noted that in order to “implement these recommendations, the Department of Health and Human Services is empowered to impose so-called ‘quality’ and ‘efficiency’ measures on health care providers. Doctors who violate a ‘quality’ standard by prescribing more life-saving medical treatment than it permits will be disqualified from contracting with any of the health insurance plans that individual Americans, under the Obama Health Care Law, will be mandated to purchase.”

“Simply put, the IPAB is bad medicine,” added Balch. “It is outrageous that a government entity would be allowed to dictate and limit what Americans could spend – of their own money – to save their own lives.”

The IPAB has come under question before and Health and Human Services Secretary Kathleen Sebelius faced questions from members of Congress over the board last year.

“The Independent Patient Advisory Board makes recommendations to Congress,” Sebelius said. “It is forbidden by law to do exactly what the Republican budget plan does. They may not shift costs to seniors. They may not change benefits.”

Tony Perkins of the Family Research Council has said the IPAB “could lead–not only to the death of patients, but also to the death of innovation.”

“This Board, made up of 15 unelected members of the President’s choosing, will be the sole authority over what kind of care–if any–we receive,” he explained. “Starting in 2015, IPAB will be tasked with bringing down medical costs–and unless Congress can find a super-majority to oppose them, IPAB’s recommendations will carry the force of law.”

“The Board could deny payment for certain care or medications, change the service options doctors have, and drive expensive, life-saving treatments out. Instead of discussing the options with your doctor, IPAB will be sitting at the controls in Washington making health decisions for you,” Perkins explained.

“What should control health care isn’t IPAB. It isn’t even Congress. What should control health care is the relationship between doctors and patients. Injecting more government into the equation only punishes patients and squeezes out the cutting-edge science that could treat them. This is just one more reason to contact your congressmen and tell them to not rest until ObamaCare is laid to rest,” Perkins said.

Balch said one of the big pro-life concerns with Obamacare is that it “requires the Independent Payment Advisory Board to make recommendations, which the federal Department of Health and Human Services is given coercive power to implement, effectively to limit what private nongovernmental resources Americans are allowed to devote to health care for their family so that they cannot even keep up with the rate of medical inflation.”

“In short, the Board will play a crucial role in limiting the ability of Americans of all ages to spend their own money to save their own lives,” Balch said. “While public attention seems focused on the Board’s impact on Medicare, too many overlook how it is charged with crafting measures that will result in the denial of life-saving medical treatment – rationing– for people of any age.”

The Medicare Decisions Accountability Act (HR 452), which is sponsored by Rep. Phil Roe (R-Tenn.) and 226 co-sponsors.