The House voted along party lines to abolish a Medicare cost control board installed by the Affordable Care Act, a.k.a. Obamacare.
“The Independent Payment Advisory Board encompasses all that is wrong with the Affordable Care Act,” said Representative Michael C. Burgess, Republican of Texas. “It is not accountable to any constituency, and it exists only to cut provider payments to fit a mathematically created target.”
The Board has regulatory power over price increases to insurance plans. Recently the Board found that increases in insurance payments that affected 42,000 consumers were not justified, and ordered the companies installing them to refund customers, rescind the increases or attempt to justify them.
Others pointed out that given the cost-saving power of the board, it is hypocritical for the GOP to want to repeal it, given how much they talk about cutting Medicare costs. The Congressional Budget Office estimated that repealing the board could increase Medicare spending by a total of $3 billion from 2018 through 2022.
Representative Alcee L. Hastings, Democrat of Florida, said: “I am appalled by the hypocrisy of my Republican colleagues who keep stating that federal spending needs to be kept under control. But at the first opportunity, they wind up rejecting one of the most serious tools in place to actually tackle Medicare spending and make care more affordable.”
The debate is one that echoes the much larger debate between conservatives and liberals: should healthcare be primarily in the market or the government? Liberals point out that making healthcare a social program decouples one's ability to see a doctor from how much money they have. Conservatives don't trust the government to run something as large as healthcare, and worry about the potential lack of choice in healthcare providers if government is running the show. What we're left with is a hodge-podge of systems based around employer-provided healthcare with patches for people who don't have employers, such as SCHIP (for children) and Medicaid (for the poor). Both sides would like to start fresh, but there are entrenched interests who make change, especially large change, very difficult.