Opinion: The Affordable Care Act does not ration health care

Submitted by gsbaird on August 3, 2013 - 12:12pm

Many opponents of Obamacare continue to rehash the same scare tactic about the Independent Payment Advisory Board (IPAB) that they have used countless times in the past. They assert that surely the IPAB will lead to severe rationing of health care, negatively affecting the lives of countless Americans.

This claim is not truthful and runs a close second to the statements selected the last two years by FactCheck.org as the winners of the ‘most outrageous pants-on-fire lies.’ Those debunked one-liners argued that the new law authorized ‘death panels’ and represented a ‘government take-over of health care.’

As written in the law, the board will consist of 15 voting members appointed by the president with the advice and consent of the Senate. Before submitting his choices, the president is directed to consult with Democratic and Republicans leaders in both houses of Congress.

The makeup of the IPAB under the Affordable Care Act, as described by the American Medical Association,  includes individuals with national recognition for their expertise in health finance and economics, actuarial science, health facility management, health plans and integrated delivery systems, health facilities reimbursement, allopathic and osteopathic physicians, other providers of health services, and other related fields that provide a mix of professionals, broad geographic representation, and balance between urban and rural areas.

IPAB members must include (but not be limited to) physicians and other health professionals, experts in the area of pharmaco-economics or prescription drug benefit programs, employers, third-party payers, individuals skilled in the conduct and interpretation of biomedical, health services, and health economics research, and expertise in outcomes and effectiveness research and technology assessment. Members must also include individuals representing consumers and the elderly.

The law specifically states that the advisory board "shall not include any recommendation to ration health care..”

Centers for Medicare and Medicaid Services (CMS), the organization that runs Medicare, has an established process that it has used for years to determine which medical treatments and procedures will be covered. CMS uses outside impartial groups to supplement its own scientific and medical expertise.  One such group is the Medical Coverage Advisory Committee (MCAC). The MCAC, which consists of six medical specialty panels and an executive committee, gives CMS its opinion on whether a specific item or service meets the criteria for Medicare coverage. However, CMS makes all final coverage decisions. This looks like a similar process to the one specified under the Affordable Care Act. Scary, huh?

In actual practice, the process works well and the vast majority of seniors are very happy with Medicare. The same will be true with the IPAB and Obamacare.