WASHINGTON - Today, Ways and Means Committee Ranking Member Sander Levin (D-MI) delivered the following remarks on the House floor in opposition to H.R. 1190, the repeal of the Independent Payment Advisory Board established under the Affordable Care Act:
The Republican leadership is yet again taking aim at ACA. 1190 would repeal the Independent Payment Advisory Board (IPAB). This would be the 59th vote to repeal or undermine ACA.
Since it passed, we have seen the slowest growth in health care prices over any period of that length in nearly 50 years. Growth in per-enrollee health care spending across both the public and private sectors has been controlled. The three slowest years of growth in real per capita national health expenditures on record were 2011, 2012, and 2013.
The ACA, in essence, has changed the health care cost landscape, keeping cost increases down and keeping, or helping at least, to keep families out of debt.
While we know the Medicare delivery system reforms have been working to deliver value and lower cost, the IPAB was created as a back stop. A back stop only to come into effect if other efforts weren’t successful.
This should be clear, IPAB only comes into being if delivery system reforms aren’t doing their job to manage Medicare.
According to the CBO, Medicare growth rates are projected to remain beneath IPAB targets throughout the entire budget window, thereby not triggering the Board’s provisions until 2024.
So here we are, on this date, at this time, nine years according to CBO before the provisions would come into effect, asking this Congress to repeal the IPAB provision.
If the ACA’s delivery system efforts continue to be successful, IPAB may never even need to be constituted.
It is specifically prohibited from cutting benefits or raising costs on seniors. What IPAB can do, however, is to make recommendations to go after overpayments, go after fraud and abuse, and try to improve, if needed, the way there’s reform of the delivery system. IPAB will not take away Medicare benefits. IPAB will not shifts costs on to seniors.
If we are doing our job as stewards of Medicare, we can manage cost growth while protecting beneficiaries on the front end. In the event IPAB makes recommendations, Congress always has the ability to disapprove or modify them. If we do our job, we won’t need IPAB. If we fail to do our job, IPAB will prod us to action nine years from now or perhaps even later.
So let me say a few words about the offset. It’s a significant reduction of funding for the Prevention and Public Health Fund. So, while the Republicans so far have come forth with their proposals that are never paid for, this time they’ve decided to have a pay-for, but it would cut by half or more the current funding for the Prevention and Public Health Fund.
That fund was established in the ACA to provide expanded and sustained national investments in prevention and public health and will provide $900 million this year alone for interventions that will reduce smoking, tackle heart disease, and help improve prenatal outcomes.
And I have a listing of what it’s meant for Michigan, just as one example. $3.5 million for state health department efforts to prevent obesity and diabetes. $3.8 million to address chronic disease risk factors among African Americans, American Indians, Latinos, and other minorities. $3.3 million for community transformation grants in central Michigan to address heart disease prevention and diabetes. And almost $3 million for tobacco use prevention.
So here we are, at long last the Republicans come forth with a pay-for and they’re paying for something that really, really matters.
We should not vote for this legislation. It would repeal a part of ACA designed to help keep health care costs under control. And, it would cut critical public health in prevention funding.
