Democrats turn Republicans’ Medicare argument against them

Republicans voted to make Medicare's fiscal woes worse with their repeal of the healthcare reform law's cost-cutting board, Democrats claimed on Thursday.

The argument seeks to turn the tables on the GOP, which has long accused Democrats of being out-of-control spendthrifts. Repealing the healthcare law's only Medicare spending backstop puts Republicans in the unusual position of supporting unlimited entitlement growth, even though it's paid for by medical malpractice caps that would reduce federal healthcare spending.


Repealing the Independent Payment Advisory Board (IPAB), which requires cuts to providers if Medicare costs grow faster than a targeted rate, "could lead to faster insolvency of the trust fund," Maryland Rep. Chris Van Hollen, the top Democrat on the House Budget Committee, told The Hill after the vote. "We believe that a lot of the reforms in the Affordable Care Act will prevent the IPAB from necessarily having to act… but the IPAB is a backstop.

"We have other reforms in the system such that we think we can drive down the costs compared to where they would go otherwise," he said. "But if we don't hit those targets, that's when IPAB kicks in."

Sen. Jay RockefellerJohn (Jay) Davison RockefellerHumorless politics a sad sign of our times Bottom Line World Health Day: It's time to fight preventable disease MORE (D-W.Va.), the provision's lead author, made the same argument in a statement after the vote.

"The Independent Payment Advisory Board was created to protect Medicare for seniors – by improving the quality of Medicare services and by extending the life of Medicare for years to come," he said.

So did the administration, when it threatened to veto the bill. 

"The bill would eliminate an important safeguard that, under current law, will help reduce the rate of Medicare cost growth responsibly while protecting Medicare beneficiaries and the traditional program," says the White House's Statement of Administration Policy.

Rep. Phil Roe (R-Tenn.) said the IPAB was the wrong solution to control costs because it would lead to rationed care as doctors started to refuse new Medicare patients as their payments got cut. 

"We are going to salvage and save Medicare," Roe told The Hill after the vote on IPAB repeal, which he championed in the House. "The IPAB is a terrible idea."

He acknowledged, however, that the IPAB repeal's medical malpractice offset, which saves $57 billion over 10 years, "isn't going to keep costs under control."

"We have to completely revise the Medicare program, there's no question about it," he said, referring to Rep. Paul RyanPaul Davis RyanPaul Ryan researched narcissistic personality disorder after Trump win: book Paul Ryan says it's 'really clear' Biden won election: 'It was not rigged. It was not stolen' Democrats fret over Trump-district retirements ahead of midterms MORE's (R-Wis.) Medicare "premium support" proposal.