Rep. Upton unsure of another repeal vote on Medicare cost board

A top Republican committee chairman said he's not sure the House will vote again to repeal President Obama's controversial Medicare cost-cutting board.

Rep. Fred Upton (R-Mich.), who leads the Energy and Commerce panel, said Wednesday that plans for the current legislative term are still in the works.

Those plans may or may not include another repeal vote for the Independent Payment Advisory Board (IPAB), a major source of enmity for Republicans, he said. 

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"I don't know. It's early in the process," Upton told a medical conference in Washington, D.C.

"I don't know that we've actually made a decision," he added in a press gaggle following the speech. "That well could be part of the mix. We haven't figured that out yet."

Following the election, House Republican Leader Eric Cantor (Va.) suggested that killing IPAB would be a priority for his conference given Obama's victory, which saved the Affordable Care Act from serious harm.

"If we successfully make the case publicly, bills that could reach the president's desk include ... repeal of IPAB," Cantor wrote to colleagues on Nov. 7. "There are some issues that I suspect [Senate Majority Leader Harry Reid (D-Nev.)] will have a difficult time compelling his members to oppose outright."

The board is tasked with cutting Medicare payments to doctors if the program's per-patient spending grows too quickly. Decisions about cuts would automatically take effect unless Congress voted to block them with equivalent savings.

Supporters say the 15-member panel is necessary to bypass partisan gridlock and prevent the explosion of federal healthcare spending.

Opponents say IPAB will intrude on lawmakers' authority and cause de facto rationing in Medicare. More vocal critics, such as former Alaska Gov. Sarah Palin (R), have likened it to a "death panel." 

Last March, the House approved legislation to repeal IPAB and institute medical liability reform. Democrats lamented the tort provisions and called for a clean IPAB repeal. Only seven supported the measure, in the end, while 10 Republicans opposed it.

Now, Reps. Phil Roe (R-Tenn.) and Allyson Schwartz (D-Pa.) have introduced another repeal bill, winning praise from the American Medical Association (AMA). That group hosted Upton at its annual conference Wednesday.

"IPAB is a panel that would have too little accountability and the power to make indiscriminate cuts that adversely affect access to healthcare for patients," AMA President Jeremy Lazarus said earlier this year.

"Patients and physicians are still struggling with the frequent threat of drastic cuts from the broken SGR Medicare physician payment formula. IPAB would be another arbitrary system that relies solely on payment cuts," he said.