Two Dems break with White House on Medicare board

Two House Democrats have signed onto a Republican bill to repeal a health reform provision that the Obama administration has touted as a central tool to keep health costs under control.

Rep. Shelley Berkley (D-Nev.) became a co-sponsor of legislation to repeal the Medicare payment board on Wednesday, one week after Rep. Michael Capuano (D-Mass.). A spokesman for the congresswoman said she remains committed to the law's cost-cutting goals but wants Congress to be in charge.

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"She believes that authority ought to remain with Congress," said David Cherry. "Everyone shares the goal of controlling costs, but how do you do it most effectively?"

The Independent Payment Advisory Board fast-tracks cuts to Medicare payments when spending reaches a pre-determined target. The Congressional Budget Office estimated that it would save $28 billion through 2019.

Peter Orzsag, the president's previous budget chief, has called the board one of the law's most important provisions for keeping Medicare sustainable.

But congressional Democrats have been under tremendous pressure from doctors and hospitals to try to nix an unelected board that directly threatens their bottom line. Over the years, the current Medicare Payment Advisory Board has seen millions of dollars worth of recommended Medicare cuts ignored by Congress.

With Democrats reluctant to pick away at their top domestic accomplishment, Republicans have moved in with proposals to repeal unpopular provisions. Rep. Phil Roe (R-Tenn.) introduced legislation to repeal the IPAB at the start of the new Congress; he was joined by Rep. John Fleming (R-La.), a family physician, who called the IPAB a Soviet-style "central planning committee."

The provision started in the Senate, and several House Democrats registered their opposition in December 2009. The Alliance for Specialty Medicine, a trade association, said it hopes more House Democrats will join the repeal effort so as to create pressure on the Senate.

"The IPAB was a creation of the Senate (...)," association spokesman Alex Valadka said in a statement. "It makes sense that the effort to repeal should begin in the House, but the only way to get the Senate to address the IPAB is for more Democrats to follow the leadership of Reps. Capuano and Berkley."

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