Dear Colleague on GOP Attempt to Repeal IPAB

November 1, 2017

Dear Democratic Colleague,

This week, Republicans will bring a bill to the floor to repeal the Independent Payment Advisory Board (IPAB) that is not paid for.  While we understand that some of us support the repeal of IPAB, we urge you to stand with us and vote against the bill.  We believe it is undeniably hypocritical for Republicans to offset the Children's Health Insurance Program, Community Health Centers and other public health extenders on the backs of beneficiaries and the nation's health, while voting to repeal IPAB without offsets.

IPAB was enacted as a backstop to the other cost saving and quality improvement efforts in the Affordable Care Act (ACA), such as accountable care organizations, patient-centered care models like medical homes, programs that pay for quality not quantity, and value based purchasing.  Because of the ACA and these programs, Medicare spending growth has slowed and Medicare's solvency has been extended.  As a result, IPAB has never been triggered, because Medicare spending growth has been below IPAB targets.  In fact, IPAB is not projected to be triggered until 2021.  Even if you support its repeal, the need for immediate action is not at all clear.

Contrary to what Republicans claim, IPAB repeal is not about helping seniors. IPAB is prohibited from sending recommendations to Congress that would harm seniors by increasing their out-of-pocket costs or cutting their benefits.  In fact, it is the Republican ACA repeal efforts that would cut nearly a trillion dollars from Medicaid and Medicare, harming seniors and other vulnerable Americans, which would have truly led to the rationing of health care.

Furthermore, IPAB repeal would increase the deficit by $17.5 billion.  This is fiscally irresponsible of Republicans, especially as they prepare to announce a tax package that will saddle our country with $1.5 trillion of debt in order to give tax cuts to the wealthy and corporations.

For these reasons, we ask that you oppose repeal of IPAB.  Now is not the time.

Sincerely,

NANCY PELOSI

Democratic Leader

FRANK PALLONE, JR.

Ranking Member

Energy and Commerce Committee

STENY HOYER

Democratic Whip

JOHN YARMUTH

Ranking Member

Budget Committee