TCC Letter: Repeal the Independent Payment Advisory Board



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November 17, 2017
The Honorable John Cornyn
Hart Senate Office Bldg, Suite 517
Washington, DC 20510

Dear Senator Cornyn:

The Texas Conservative Coalition (TCC) is writing to express our support for H.R. 849 and S. 260, which would repeal the Independent Payment Advisory Board (IPAB) – a central feature of the Patient Protection and Affordable Care Act (PPACA).

H.R. 849 (Roe, R-TN) passed the House on November 2 with bipartisan support, garnering 225 Republican and 45 Democrat cosponsors. We urge the Senate to also pass the bill – or its companion, S. 260 by Senator Cornyn (R-TX) – and send the legislation to President Trump.

In 2013 and again in 2015, TCC joined hundreds of organizations around the nation in calling for the elimination of the IPAB, one of the worst provisions of the PPACA.

The IPAB recommends cost-cutting measures that would take effect automatically unless Congress enacts an alternative that saves an equal amount of money. Such a mechanism improperly transfers key powers of the legislative branch to that of the executive. This unelected board of 15 bureaucrats would be authorized to cut billions of dollars in Medicare funding without Congressional approval. Former Obama administration Office of Management and Budget Director Peter Orszag has publicly stated that the creation commissions like IPAB was a way to “counter the gridlock of our political institutions by making them a little less democratic.” This admission speaks volumes.

Thankfully, the IPAB has not yet convened and no members have been appointed to the Board. However, if no board is appointed and Medicare passes a critical spending threshold, then the power to make the cost-cutting decision is granted to the sole authority of the U.S. Secretary of Health and Human Services.

Ultimately, TCC agrees with the American Medical Association (AMA) and 650 other organizations that took the following position on IPAB in a joint letter that “an unelected board without adequate oversight or accountability would be taking actions historically reserved for the public’s elected representatives in the U.S. House and Senate. This is an unacceptable decision making process for a program that millions of our nation’s seniors and individuals with disabilities rely upon.” Indeed, as Ways and Means Committee Chairman Kevin Brady (R-TX) said:

Putting Medicare on sustainable financial footing is a top priority for this Committee, but passing the buck to a handful of unaccountable bureaucrats is not the right approach.

Rather than take control away from the American people, we should expand choice, access, flexibility, and competition in Medicare. And we can start right now by passing this legislation to terminate the IPAB once and for all.

The IPAB is one of the worst provisions of the Patient Protection and Affordable Care Act. It is undemocratic, unaccountable, and would limit choices in health care. TCC supports your efforts to advance and pass legislation that would repeal it.


Representative James Frank
Representative Jason Isaac
Representative Jodie Laubenberg
Representative Geanie Morrison
Representative Greg Bonnen, M.D.
Representative Cindy Burkett
Representative Dan Flynn
Representative Craig Goldman
Representative Phil King
Representative Matt Krause
Representative Jim Murphy
Representative Tan Parker
Senator Paul Bettencourt
Senator Brandon Creighton
Senator Craig Estes
Senator Bob Hall
Senator Don Huffines
Senator Bryan Hughes
Senator Lois Kolkhorst
Senator Charles Perry
Senator Kel Seliger
Senator Larry Taylor
Representative Cecil Bell
Representative Dennis Bonnen
Representative DeWayne Burns
Representative Angie Chen Button
Representative Briscoe Cain
Representative Drew Darby
Representative Pat Fallon
Representative Cole Hefner
Representative Todd Hunter
Representative Mark Keough
Representative Stephanie Klick
Representative Stan Lambert
Representative Mike Lang
Representative Jeff Leach
Representative Will Metcalf
Representative Rick Miller
Representative Andrew Murr
Representative Tom Oliverson, M.D.
Representative Dennis Paul
Representative Matt Rinaldi
Representative Scott Sanford
Representative Matt Shaheen
Representative Drew Springer
Representative Lynn Stucky, D.V.M
Representative Valoree Swanson
Representative Ed Thompson
Representative James White
Representative Paul Workman
Representative John Wray

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