Does the Independent Payment Advisory Board = “Death Panels”?

“Death Panels” has been a heated term of debate within the overall controversy that is the PPACA (Obamacare). It surfaced in 2009 when former Alaskan Governor used the term “death panels” in reference to the Independent Payment Advisory Board (IPAB) during a healthcare debate. The IPAB is a 15 member panel of unelected “experts” appointed by the President and confirmed by the Senate with its main purpose to reduce Medicare spending.


The term “death panels” arose when Sarah Palin, former Alaskan governor, asserted in a 2009 debate that The PPACA (Obamacare) legislation provided for a panel of bureaucrats to determine whether or not the elderly and disabled were worthy of care. Palin said she was referring to Section 1233 of bill HR 3200. This section would have allowed Medicare to pay physicians for providing voluntary counseling to patients about living wills, advance directives, and end-of-life care options. The appointments for these discussions would have been voluntary and not mandatory under this section of the bill. However, due to the controversy surrounding the “death panels,” Section 1233 was not included in the final bill which became the PPACA.
Excluding Section 1233 didn’t end the “death panel” claims though. In June of 2012, Sarah Palin once again addressed that she was referring to the IPAB as the “death panels” in a facebook post: “Though I was called a liar for calling it like it is, many of these accusers finally saw that Obamacare did in fact create a panel of faceless bureaucrats who have the power to make life and death decisions about health care funding. It’s called the Independent Payment Advisory Board (IPAB), and its purpose all along has been to “keep costs down” by actually denying care via price controls and typically inefficient bureaucracy.”
However, in Section 3403 (2)(A)(ii) of Obamacare, IPAB is specifically prohibited by law from recommending any policies that ration care, raise taxes, increase premiums or cost-sharing, restrict benefits or modify who is eligible for Medicare or “…increase Medicare beneficiary cost sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria.”
IPAB is an advisory board made up of 15 unelected members appointed by the President and confirmed by the Senate. Their main purpose is to reduce and control health costs contributing to the growth in Medicare spending. The Congressional Budget Office (CBO) estimates savings due to IPAB of $28 billion in Medicare spending between 2010-2019. CBO also estimated that getting rid of IPAB would actually increase the national deficit by $3.1 billion and grow health care expenditures unless other Medicare reform was enacted.
“IPAB would recommend policies to Congress to help Medicare provide better care at lower costs. This could include ideas on coordinating care, getting rid of waste in the system, incentivizing best practices, and prioritizing primary care.” If IPAB does not hit its target by 2018, they must submit a plan to the White House and Congress about what cuts are necessary. “Congress could pass a different set of cuts or reject the IPAB recommendations with a three-fifths vote in the Senate.”
This doesn’t calm everyone’s fears, however. Republican Senator Tom Coburn sees the IPAB similarly to Palin, “it means the bureaucrats and politicians are in charge of your health care.” The CATO Institute also claims this makes the IPAB a “super legislature.” It states, “Obamacare requires IPAB to issue ‘legislative proposals’ to reduce future spending… But the really dangerous part is that these are not mere ‘proposals’." Obamacare requires the secretary of Health and Human Services to implement them — which means they become law automatically — unless Congress takes certain steps to head them off.”
References to “death panels” are a matter of interpretation of the IPAB, its purpose, and the amount power they are being given under the PPACA. While the White House refuses to accept the term is applicable due to what is written in black and white within the law itself, people who use the term do so by referring to the same piece of legislation and its lack of specifics and definitions of important terminology.


Opponents View:

Who defines the term “rationing” of healthcare? Proposals by a board of unelected individuals to reduce spending could jeopardize seniors’ access to critical medical care.
Other sensible reforms can be made to reduce cost without creating an over-empowered group of unelected “experts” who can negatively affect care.

Proponents View:

IPAB is an important way to reduce the increasing cost of Medicare and the law will prohibit rationing of care and discriminating against the elderly, sick, and disabled.

Ask Yourself:

  • Are you concerned with the addition of a panel of unelected individuals who have the power of the IPAB?
  • Do you think that the IPAB is a “death panel” and will make end-of-life decisions to save money?
  • Do you think that your elderly and disabled family members will be treated differently now that the IPAB is part of an active law?