By Elise Viebeck - 08/08/13 09:00 AM EDT
ObamaCare’s cost-cutting board — memorably called a “death panel” by Sarah Palin — is facing growing opposition from Democrats who say it will harm people on Medicare.
Former Democratic National Committee Chairman Howard Dean drew attention to the board designed to limit Medicare cost growth when he called for its repeal in an op-ed late last month.
But the former Vermont governor is not the only Democrat looking to kill the panel.
A wave of vulnerable Democrats over the past three months has signed on to bills repealing the board’s powers, including Sen. Mark Pryor (Ark.) and Reps. Ron Barber (Ariz.), Ann Kirkpatrick (Ariz.), Kyrsten Sinema (Ariz.) and Elizabeth Esty (Conn.).
All five are considered vulnerable in next year’s election, highlighting the stakes and the political angst surrounding the healthcare measure.
The four House Democrats faced criticism from their party in July after voting with Republicans to delay ObamaCare's individual and employer mandates — moves widely interpreted as political positioning ahead of 2014.
Two of the lawmakers explained their opposition by suggesting the board would limit care for Medicare patients.
But the National Republican Congressional Committee (NRCC) blasted the four Democrats for “desperately trying to jump off the ObamaCare train.”
The cost-cutting board has been dogged with controversy over the last three years.
Major healthcare interests like the American Medical Association, the American Hospital Association and the pharmaceutical lobby have supported IPAB repeal, saying the panel would cut providers' pay arbitrarily.
Public awareness of the board shot up last year when Palin called it a “death panel,” connecting the IPAB to her previous attacks on a proposal to encourage end-of-life planning in the Affordable Care Act.
“Though I was called a liar for calling it like it is, many of these accusers finally saw that ObamaCare did in fact create a panel of faceless bureaucrats who have the power to make life and death decisions about healthcare funding,” Palin wrote on Facebook.
This claim experienced a revival on the right after Dean published his op-ed, which argued that the board would ultimately ration care for Medicare patients.
“The IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them,” Dean wrote in The Wall Street Journal.
“Getting rid of the IPAB is something Democrats and Republicans ought to agree on.”
The piece quickly went viral, prompting conservative bloggers and Fox News hosts to cheer: “Dean confirms that Sarah Palin was right!”
The IPAB is designed to kick in when Medicare cost growth grows above a specified rate. It is charged with making recommendations on how to reduce Medicare spending, and its proposals are required to be fast-tracked through Congress.
The Affordable Care Act prevents the IPAB from making recommendations that would directly ration care. But critics say reducing provider reimbursements would have the same result by making it difficult for healthcare professionals to make money in Medicare.
While it's unlikely the board will be convened soon, Medicare cost growth is not high enough to trigger its work, and any nominees would face long confirmation fights in the Senate, Dean's op-ed renewed focus on bills to repeal the IPAB.
The Senate and House measures currently have 32 and 192 co-sponsors, respectively, including 22 Democrats in the House. Co-sponsors include lawmakers like Rep. John Barrow (D-Ga.), a longtime GOP target.
But calls for repeal are not taking up the whole debate.
Dean’s piece also drew strong arguments in favor of the panel from supporters like Peter Orszag.
The former White House budget director said the IPAB is necessary in light of Medicare’s transition to new payment models that are meant to lower costs while improving care.
It's preferable to the “old way,” which saw Congress “simply slash Medicare payments” to providers, Orszag wrote in a column for Bloomberg.
“The point of having such a board — and here I can perhaps speak with some authority, as I was present at the creation — is to create a process for tweaking our evolving payment system in response to incoming data and experience, a process that is more facile and dynamic than turning to Congress for legislation,” he wrote.
In the meantime, the Democratic National Campaign Committee (DCCC) is warding off criticism of the anti-IPAB Dems with a push to turn the ObamaCare tables on the GOP.
The committee pointed to evidence Wednesday that resisting the healthcare law could hurt Republicans in the next election.
A new poll commissioned by the Service Employees International Union found that undecided voters prefer an anti-repeal Democrat over a pro-repeal Republican in a generic match-up.
“Instead of fighting old political battles on healthcare, polling shows that Americans want Republicans to work with Democrats to implement Obamacare and move on to focus on creating good jobs,” said Emily Bittner, a spokeswoman with the DCCC.
“The public strongly disapproves of Republicans’ plan to give insurance companies free rein over our health care.”