Republicans take on cost-cutting panel backed by budget chief Orszag

Several Senate Republican leaders are now pushing a new, partial health-overhaul repeal bill that targets a Medicare cost-cutting panel, The Hill reports. The panel, the Independent Payment Advisory Board, would make cost-cutting recommendations whenever spending exceeds set benchmarks. Congress would have to adopt them, or come up with its own plan. "The Republican critics — Sens. John Cornyn (Texas), Jon Kyl (Ariz.), Orrin Hatch (Utah), Pat Roberts (Kan.) and Tom Coburn (Okla.) — argue that "unelected, unaccountable bureaucrats" shouldn't be granted such significant powers over the healthcare of seniors" (Lillis, 7/28).

Cornyn, the bill's lead sponsor, said the IPAB provision is "the definition of a government takeover" of health care, the Austin Business Journal reports. "America's seniors deserve the ability to hold elected officials accountable for the decisions that affect their Medicare," he said. According to the law, the panel "can not ration health care, raise premiums, increase cost-sharing, restrict benefits or modify Medicare eligibility. Changes must also strive to improve health care delivery and outcomes" (7/28).

In a press release, the Alliance of Specialty Medicine backed the bill, titled the Health Care Bureaucrats Elimination Act. The press release was republished by the Biloxi (Miss.) Sun-Herald (7/27).

Where did IPAB come from? The New York Times reminds today that soon-to-be-former White House budget director Peter Orszag, "was the administration's main proponent of 'bending the curve' on health care expenditures. Frustrated that House Democrats wouldn't accept some painful cost-cutting measures in the new health care law, Mr. Orszag pushed for and won a controversial provision to create something called the Independent Payment Advisory Board." The 15 person board that will begin proposing cuts in 2014 also shows Orszag's propensity for shifting the balance of power from Congress to the executive branch, the Times writes (Bai, 7/28).

In a speech Wednesday, Orszag urged Congress to commit to making politically difficult spending cuts, The Hill reports. He said, "The single greatest driver of our long-term deficit is rising growth in healthcare costs… We cannot cut other spending or raise revenue enough. The math simply does not work in any viable way." The remarks came in his last speech as Office of Management and Budget director (Alarkon, 7/28).