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House Republicans Debate Future of IPAB with HHS Secretary

By Rebecca Adams, CQ HealthBeat Associate Editor

President Obama is "in discussion with a number of potential nominees" for the Independent Payment Advisory Board (IPAB), Health and Human Services Secretary Kathleen Sebelius told lawmakers at a hearing. But she suggested that there is no rush to name the board members because it doesn't need to begin work until 2013.

Two witnesses at the House Energy and Commerce Health Subcommittee session—American Enterprise Institute fellow Scott Gottlieb and Georgetown Public Policy Institute professor Judith Feder—said that they had discussed joining IPAB with the administration or congressional staff.
Gottlieb said he wasn't inclined to serve on IPAB. Feder said she had brought it up with the administration because she would be "proud to serve."

At what was a tense hearing, Texas Republican Rep. Michael C. Burgess noted that the $15 million budget for IPAB will become available Oct. 1. Sebelius noted that IPAB's first recommendations are not due until January 2014, and she assured GOP members that "there will be no drawdown of the Treasury of $15 million until there is a board."

The session featured many of the same tensions over both IPAB and each party's Medicare proposals that were evident in the House Budget Committee hearing. Sebelius criticized the House GOP budget resolution, saying it "shifts costs onto seniors" and "does contemplate an end to Medicare as we know it" because it marks an "end to guaranteed benefits."

"It'd be a voucher system in a private insurance market," Sebelius said.

The secretary was then lectured by Republicans, who said she should use the phrase "premium support" to describe their plan because the term "voucher" is inaccurate and pejorative.

Jan Schakowsky, D-Ill., later said that Medicare should not continue to use its name under the GOP budget proposal, saying it could be called "Sorta Care or Maybe Care or I Don't Care but it's not Medicare anymore," because it would guarantee a contribution toward beneficiaries' coverage, but not a long list of benefits.

The two parties also mostly disagreed over IPAB, although subcommittee ranking Democrat Frank Pallone Jr. of New Jersey said that he also would like to get rid of IPAB.

"One of the reasons I'm opposed to IPAB," Pallone said, is that "I thought in the Affordable Care Act that we did a very good job of keeping costs down . . . We don't need IPAB."

He also said he is concerned that IPAB would be similar to the Base Realignment and Closure Advisory Committee (BRAC) process, which he called "totally stacked against Congress."

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