RECENT VOTES

Health Care

On Tuesday, June 23, 2015 the House considered H.R. 1190, Protecting Seniorsí Access to Medicare Act of 2015. This legislation eliminates the Independent Payment Advisory Board (IPAB), which was established by the Affordable Care Act (ACA) as a way to contain Medicare costs. The IPAB is one of the ACA provisions that most concerned me when health care reform was being debated. The ACA shifted the authority to set Medicare policies and reimbursement rates from Congress to the IPAB, with members appointed by the President. It effectively takes Congress out of the discussion about Medicare reimbursement. Historically, reimbursement rates from Medicare have taken into account a variety of factors, including cost, the complexity of medical issues and whether a provider engages in scientific research to advance medicine. My concern over the IPAB has been that if it considers cost only when determining rates, Massachusetts could lose billions of dollars. There is no question that such a significant financial loss would hurt our medical schools, teaching hospitals and research programs. That in turn will result in the loss of jobs which will hurt the local economy.

Furthermore, there was no Congressional oversight whatsoever with the IPAB. The President appoints its members and Congress has no authority over its work. It should be pretty clear by now that many Republicans want to repeal the entire ACA. What happens with the IPAB and the ACA when President Obama is no longer in office? Future Presidents may have very different approaches to those they appoint and the role of the IPAB.

I donít like the way H.R. 1190 pays for repeal of the IPAB but I have never accepted the premise that this board will save money Ė so repealing it wonít stand in the way of savings. I voted YES. H.R. 1190 passed and the entire vote is recorded below:

  YEA NAY PRESENT NOT VOTING
REPUBLICAN

233

0

0

12

DEMOCRAT

11

154

0

23

TOTAL

244

154

0

35

MASSACHUSETTS
DELEGATION

2

7

0

0