Protecting Seniors' Access to Medicare Act of 2015

Floor Speech

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Mr. PITTS. Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today in support of H.R. 1190, the Protecting Seniors' Access to Medicare Act of 2015.

Mr. Speaker, the bill before us today repeals the Independent Payment Advisory Board, IPAB, one of the most ominous provisions in the sweeping overhaul of health care known as the Affordable Care Act.

The stated purpose of IPAB is to reduce Medicare's per capita growth rate. The Board is to be made up of 15 unelected, unaccountable bureaucrats--by the way, you can't have a majority of docs on the Board--who will be paid $165,300 a year to serve 6-year terms on the Board.

This panel of 15 unelected and unaccountable government bureaucrats is tasked with reducing Medicare costs through arbitrary cuts to providers, limiting access to care for seniors. If Medicare growth goes over an arbitrary target, the Board is required to submit a proposal to Congress that would reduce Medicare's growth rate.

These recommendations will automatically go into effect, unless Congress passes legislation that would achieve the same amount of savings. In order to do so, Congress must meet an almost impossible deadline and clear an almost insurmountable legislative hurdle.

The Board has the power to make binding decisions about Medicare policy, with no requirement for public comment prior to issuing its recommendations, and individuals and providers will have no recourse against the Board because its decisions cannot be appealed or reviewed. In other words, the Board will make major healthcare legislation essentially outside the usual legislative process.

The Board is also limited in how it can achieve the required savings. Therefore, IPAB's recommendations will be restricted to cutting provider reimbursements. In many cases, Medicare already reimburses below the costs of providing services; and we are already seeing doctors refusing to take new Medicare patients--or Medicare patients at all--because they cannot afford to absorb the losses.

Any additional provider cuts will lead to fewer Medicare providers, and that means that beneficiary access will suffer. Seniors will be forced to wait in longer and longer lines to be seen by an ever-shrinking pool of providers or have to travel longer and longer distances to find a provider willing to see them.

Clearly, Medicare growth is on an out-of-control trajectory that endangers the solvency and continued existence of the program. IPAB, however, is not the solution.

Mr. Speaker, the House voted 223-181 in 2012 to repeal the Independent Payment Advisory Board. Today, H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015, enjoys the support of 235 of our House colleagues who have signed on as cosponsors.

The time has come for the House to once again repeal this flawed policy, and I urge all of my colleagues to support H.R. 1190.

I reserve the balance of my time.

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Mr. PITTS. Mr. Speaker, I would say to the distinguished minority whip, I do support Ex-Im Bank and urge my leaders to act on it. We are together on support of that.

Let me just mention a few things to correct the record. Number one, we had Secretary Burwell before the committee earlier this year and Dr. Larry Bucshon, on our Health Subcommittee, asked her specifically, when the IPAB cuts would begin to take effect. She said in 2019. In fact, the President's own budget request would begin the cuts of IPAB in 2019.

Now, you don't have to have the members of the IPAB appointed in order to have the cuts. The law, IPAB, designates the Secretary of HHS with the authority to make those cuts. To overcome those cuts, you really have to have two-thirds votes in the House and the Senate, with commensurate cuts from somewhere else in Medicare to replace those cuts that you are overcoming.

So this is a Board that has tremendous power that will deal with provider payments and cuts.

We just dealt with the SGR, the sustainable growth rate, in a bipartisan manner. We acted to repeal the sustainable growth rate that required cuts to provider payments for seniors, and it was supported overwhelmingly.

But if you liked the SGR, you will love IPAB. This is the SGR on steroids. It will be very difficult to overcome these 15 unelected bureaucrats, experts, whatever you want to call them--it can't be a majority of docs, by the way--or the Secretary, whoever makes the recommendations.

We use the prevention fund as a pay-for, taking funds from the prevention fund until 2025 to reach the $7.1 billion. But this prevention fund gets $2 billion every year, beginning this year and every year ad infinitum. So $2 billion in 2015, 2016, '17, '18, '19, '20, '21, '30, '31, '40, '41. Every year, the Secretary gets $2 billion to use at her sole discretion. She doesn't have to use it for public health purposes. She has sole discretion on how this money is used.

Would you like to know some of the things she has used the money for so far?

Well, $450 million was used for the Navigator program and implementing the Affordable Care Act; $400,000 has been used for pickle-ball; $235,000 for massage therapy, kick boxing, and Zumba classes, whatever that is; $7.5 million on promoting free pet neutering; $3 million for the New York Department of Health to lobby for the passage of a soda tax; money for gardening projects, fast food, small businesses, bike clubs.

Rather than spend money on questionable projects, lobbying campaigns for higher taxes, and for Affordable Care Act media campaigns, H.R. 1190 would rather use these funds to protect Medicare seniors and their health care because the money for the operation of IPAB, for these salaries, for their travel, for all their expenses comes directly out of the trust fund moneys for seniors, used for seniors and those with disabilities. That is wrong.

We are constraining. We are not repealing the prevention fund to pay for this, but we need to constrain the use of that fund. And good public health policy ought to come before the Congress, not be at the sole discretion of this one Secretary or czar or however you might want to term it.

So, Mr. Speaker, I am pleased to speak in favor of this legislation, H.R. 1190, and I urge the Members to support it.

I reserve the balance of my time.

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Mr. PITTS. Mr. Speaker, I yield myself the balance of my time.

While the programs enumerated by the gentleman from Maryland are laudable, there is nothing in the prevention and public health fund that guarantees that these will be funded or that they are priorities. It is at the sole discretion of the Secretary as to what she would allocate the funds for. And rightly, these kinds of funds should come before Congress, and Congress should approve these kinds of public health funds.

I might mention that CBO estimates that H.R. 1190, the Protecting Seniors' Access to Medicare Act of 2015, as amended, would have no budgetary effect on fiscal years 2015-16. It would reduce direct spending by $1.8 billion over the 2016-2020 period, and reduce the direct spending by $45 million over the 2016-25 period.

With that, Mr. Speaker, I urge Members to support H.R. 1190, the Protecting Seniors' Access to Medicare Act, and repealing IPAB.

I yield back the balance of my time.

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