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Much-Criticized IPAB Gets a Boost in Kaiser Poll

By Jane Norman, CQ HealthBeat Associate Editor

Americans appear to have more confidence in the ability of an independent panel to trim Medicare spending than they have in bureaucrats, politicians or insurers, according to a new poll released by the Kaiser Family Foundation.

Among those surveyed in the June poll, half said they would trust "a fair amount" or "a great deal" an independent panel of full-time experts with members appointed by the president and confirmed by the Senate.

About 40 percent would instead place their trust in the Centers for Medicare and Medicaid Services, 34 percent in Congress and 34 percent in private health insurance companies.

A Kaiser analysis notes that when it comes to trust, no one group gets an "overwhelming" level of support, but the independent board beats the other choices. Broken down by party identification, Democrats trust an independent panel more than Republicans, who say they are more likely to trust insurers.

Overall, 31 percent said they would trust Congress "not at all" to make proposals about Medicare spending, and 33 percent said they would trust Congress "just a little."

The poll results come as debate intensifies over the role of the Independent Payment Advisory Board, which was created in the health care law (PL 111-148, PL 111-152) and is intended to issue by 2014 recommendations about how Medicare spending has reduced.

Under the law, starting in 2014, IPAB will have the power to issue recommendations to reduce Medicare spending if it exceeds certain levels. Congress can block the board's recommendations from taking effect, but it is not easy to do so.

Republicans have been stepping up their criticism of the board for having too much power and too little oversight, as have health advocacy organizations. A GOP bill to repeal IPAB (HR 452) has picked up 144 cosponsors, including seven Democrats.

The Energy and Commerce Subcommittee on Health has scheduled a July 13 hearing on IPAB's "controversial consequences for Medicare and seniors."

Also in the poll, those surveyed said that they would prefer spending reductions instead of tax increases as a main approach to reducing the deficit, with about 47 percent saying that is preferable. Just 16 percent said they liked tax increases as a better alternative.

The question is an important one given current tension-filled negotiations over reducing the deficit in time to raise the debt ceiling by an Aug. 2 deadline.

But an analysis of the poll pointed out that previous surveys have found it is much more difficult to find agreement among members of the public when it comes to specific areas of spending that could be cut. In the May tracking poll, majorities said they would not accept any reductions in spending on Social Security, Medicare or Medicaid.

The June poll asked a somewhat different question: whether people would be willing to accept Medicare reductions for specific purposes. It found 45 percent said they would back "minor" cuts to trim the deficit, and 18 percent said they would accept "major" reductions.

There was more support for using the money saved for the Medicare program rather than another purpose. To prevent Medicare from going bankrupt, 42 percent would accept minor reductions and 32 percent would accept major reductions. Similarly, to prevent a Medicare funding shortfall, 49 percent would accept minor reductions and 23 percent would accept major reductions.

Kaiser also regularly asks about people's view of the health care law and found little had changed in June compared to previous polls—42 percent hold a favorable view and 46 view it unfavorably, with partisan lines drawn in the responses. The unfavorable view had increased slightly from 44 percent in May.

The poll was conducted June 9 through June 14 among a nationally representative sample of adults age 18 and older, using both land-line telephones and cell phones. The margin of error is plus or minus 3 percentage points in the total sample and may be higher among subgroups.

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