Affordable Care Act Includes Independent Payment Advisory Board

Independent Payment Advisory Board (IPAB) Is An “Expert Body” With 15 Health Care Experts Appointed By The President And Confirmed By the Senate. According to the Center on Budget and Policy Priorities:

The Independent Payment Advisory Board is an expert body charged with developing and submitting proposals to slow the growth of Medicare and private health care spending and improve the quality of care. The President nominates the board's 15 members, who require Senate confirmation, for staggered six-year terms. The board must include physicians and other health professionals, experts in health finance, health services researchers, employers, and representatives of consumers and the elderly.  To prevent control by special interests, health care providers may not constitute a majority of the board's membership. [Center on Budget and Policy Priorities, 3/15/12]

IPAB “Will Help Slow The Growth Of Medicare Costs.” According to the Center on Budget and Policy Priorities:

The health reform legislation enacted in 2010 (the Affordable Care Act, or ACA) establishes the Independent Payment Advisory Board, or IPAB -- a presidentially appointed commission that will help slow the growth of Medicare costs if those costs are projected to exceed a specified target level.[1] Other cost-control measures included in the ACA will likely produce most or all of the savings needed to meet the spending target, but IPAB serves as an important backstop to contain costs if these measures prove inadequate. [Center on Budget and Policy Priorities, 3/15/12]

Right-Wing Media Use IPAB To Resurrect “Death Panels” Lie

Fox's Sarah Palin: “Of Course There Are Death Panels” In “Evil” Obamacare. During a segment on Fox News' Cashin' In, Fox News contributor Sarah Palin advanced the “death panels” myth, saying:

PALIN: Of course there are death panels in there. But the important thing to remember is that's just one aspect of this atrocious, unaffordable, cumbersome, burdensome evil policy of Obama's and that is Obamacare. [Fox News, Cashin' In, 8/10/13]

Breitbart.com's John Nolte: Death Panels “Are Already A Part Of Obamacare.” Breitbart.com columnist John Nolte claimed that “death panels” are included in the health care law:

The first services usually axed by death panels staffed with a handful of bureaucrats are the costly and uncertain experimental procedures that sometimes fail many times before leading to a breakthrough, as well as expensive, life-saving operations on the ill, handicapped, and elderly.

Some Democrats, most notably Howard Dean, are already pushing back against the “death panels” that are already a part of ObamaCare. [Breitbart.com, 8/10/13] 

Fox's Marc Siegel: IPAB Is “A Death Panel, It's A Rationing Board.” On Fox News' Your World with Neil Cavuto, Fox News contributor Dr. Marc Siegel called the IPAB “a death panel” and “a rationing board.” [Fox News, Your World with Neil Cavuto, 8/6/13, via Media Matters]

Fox's Eric Bolling: IPAB Decides “What Medical Treatment I'm Going To Be Able To Get.” On Your World, Fox host Eric Bolling said that “the whole point of [IPAB] is to decide what medical treatment I'm going to be able to get.” [Fox News, Your World with Neil Cavuto, 8/6/13, via Media Matters]

Rush Limbaugh: “Death Panels” Will Decide “Who Gets What, Who Gets Paid For And Who Doesn't.” On his radio show, Rush Limbaugh claimed, “There's a thing in Obamacare called death panels that are going to decide what, you know, who gets what, who gets paid for and who doesn't.” [Premiere Radio Networks, The Rush Limbaugh Show, 8/1/13]

Fox's Sean Hannity: “Obamacare Death Panels Are In Fact Alive And Well.” On his Fox News show, Sean Hannity said that “there is new evidence to suggest the so-called Obamacare death panels are in fact alive and well.” Hannity interviewed Palin, who said that her “claim that death panels were a part of Obamacare and the rationing of health care services” has “proven to be true.” [Fox News, Hannity, 7/30/13, via Nexis]

To see Fox News' history of advancing the “death panels” myth, click here, here, here, and here.  

Law Does Not Allow IPAB To Recommend Rationing Health Care

Health Care Law Explicitly States That IPAB Cannot Make “Any Recommendation To Ration Health Care.” The text of the ACA confirms that IPAB cannot make “any recommendation to ration health care... or otherwise restrict benefits or modify eligibility criteria”:

The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost- sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria. [Patient Protection and Affordable Care Act, accessed 8/13/13, OpenCongress.org]

PolitiFact: IPAB “Wouldn't Make Any Health Care Decisions For Individual Americans.” A PolitiFact analysis of the claim that IPAB would make the final decision on available treatments found that IPAB would make broad policy decisions, not individual recommendations. It also noted that IPAB is “forbidden from submitting 'any recommendation to ration health care'”:

The health care law directs a new national board -- with 15 members who are political appointees -- to identify Medicare savings. It's forbidden from submitting “any recommendation to ration health care,” as Section 3403 of the health care law states. It may not raise premiums for Medicare beneficiaries or increase deductibles, coinsurance or co-payments. The IPAB also cannot change who is eligible for Medicare, restrict benefits or make recommendations that would raise revenue.

What it can do is reduce how much the government pays health care providers for services, reduce payments to hospitals with very high rates of re-admissions or recommend innovations that cut wasteful spending. Some argue that because the IPAB can reduce the money a doctor receives, this could lead to an indirect form of rationing.

But the board wouldn't make any health care decisions for individual Americans. Instead, as PolitiFact Georgia reported, it would make broad policy decisions that affect Medicare's overall cost. [PolitiFact, 10/4/12]

Wash. Post's Glenn Kessler: The ACA “Explicitly Says That The Recommendations Cannot Lead To Rationing Of Health Care.” Washington Post fact checker Glenn Kessler wrote that IPAB “appears aimed at doing the same thing as the House Republican Medicare plan”:

The health-care law explicitly says that the recommendations cannot lead to rationing of health care. Of course, “rationing” is in the eye of beholder, and one common complaint is that rationing is not defined. The law also limits recommendations that would change benefits, modify eligibility or increase Medicare beneficiary cost-sharing, such as deductibles, coinsurance and co-payments.

On the surface, the IPAB appears aimed at doing the same thing as the House Republican Medicare plan -- reducing the runaway costs of Medicare, except on a faster track. (The GOP plan would not kick in until 2021, just a few years before the Medicare hospital fund begins to run dry.) [The Washington Post, 10/4/12]

PolitiFact Named “Death Panels” Its 2009 “Lie Of The Year”

PolitiFact: “Of All The Falsehoods And Distortions In The Political Discourse This Year,” Death Panels “Stood Out From The Rest.” In December 2009, PolitiFact named “death panels” its 2009 “Lie of the Year”:

Of all the falsehoods and distortions in the political discourse this year, one stood out from the rest. 

“Death panels.”

The claim set political debate afire when it was made in August, raising issues from the role of government in health care to the bounds of acceptable political discussion. In a nod to the way technology has transformed politics, the statement wasn't made in an interview or a television ad. Sarah Palin posted it on her Facebook page. 

Her assertion -- that the government would set up boards to determine whether seniors and the disabled were worthy of care -- spread through newscasts, talk shows, blogs and town hall meetings. Opponents of health care legislation said it revealed the real goals of the Democratic proposals. Advocates for health reform said it showed the depths to which their opponents would sink. Still others scratched their heads and said, “Death panels? Really ?”

The editors of PolitiFact.com, the fact-checking Web site of the St. Petersburg Times , have chosen it as our inaugural “Lie of the Year.” [PolitiFact, 12/18/09]