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Letter to the House Committee on Energy and Commerce, Subcommittee on Health, opposing the Medicare Decisions Accountability Act

March 07, 2012

Dear Representative:

On behalf of the more than three million members of the National Education Association, we urge your opposition to the Medicare Decisions Accountability Act (H.R. 452) when it comes before the Energy and Commerce Committee, Subcommittee on Health.  This misnamed legislation would actually repeal the Independent Payment Advisory Board (IPAB) charged with recommending policies to Congress to help the Medicare program provide better services at lower cost.

Contrary to rhetoric about reducing the cost of entitlements, this legislation would do the exact opposite by erasing the common sense process established in the Affordable Care Act (ACA) to slow Medicare cost-growth, while protecting seniors and disabled individuals from benefit cuts, cost-sharing increases, eligibility changes and rationing.

The ACA requires the IPAB to consider recommendations that improve health outcomes by promoting care coordination, prevention, quality, and efficiency while protecting and improving Medicare beneficiaries’ access to necessary care.  It explicitly prohibits the IPAB from making recommendations that ration health care, raise taxes, increase beneficiary premiums or cost-sharing, restrict benefits, or change eligibility criteria.  The Board would ensure that Medicare payment policies are determined by experts, using scientific evidence, not special interest groups and those who benefit financially from the program.

Congress has the authority to reject the IPAB’s recommendations and replace them with a different proposal that would achieve the same level of savings.  Only if Congress fails to take action to supplant the IPAB’s recommendations would they be submitted to the Department of Health and Human Services for implementation.

The IPAB would set strict goals for Medicare spending and will operate as a backstop to ensure that health costs are reduced.  We believe it offers a reasonable approach to ensuring efficiency in the Medicare program without jeopardizing beneficiaries’ access to quality services.  We urge your opposition to its repeal. 


Kim Anderson  
Director, Center for Advocacy

Mary Kusler
Director of Government Relations