In a letter to President Obama, House Speaker Boehner (R-OH) and Senate Republican Leader Mitch McConnell (R-KY) announced that they are declining to recommend Republican appointments to the Independent Payment Advisory Board (IPAB). The board, established by section 3403 of the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148) and codified in section 1899A of the Social Security Act, is designed to reduce the per capita rate of growth of Medicare spending. When certain conditions are met the IPAB members will meet and develop recommendations for Congress to reduce Medicare spending. The board is limited in how it can reduce spending. The members of the IPAB are to be appointed by the President and confirmed by the Senate. To date no one has been appointed to the board.

Membership is to be composed of 15 individuals and include physicians and health care professionals from various health care professions and regions of the country. On March 29, 2013, President Obama requested recommendations for IPAB membership from Speaker Boehner and Leader McConnell. In their joint response, they stated that “because the law will give IPAB’s 15 unelected, unaccountable individuals the ability to deny seniors access to innovative care, we respectfully decline to recommend appointments.”

The letter went on to state that the leaders hope that establishing the IPAB never becomes a reality as a full repeal of PPACA remains the goal of both leaders. According to the letter Speaker Boehner and Leader McConnell believe that they should “work in a bipartisan manner to develop the long-term structural changes that are needed to strengthen and protect Medicare for today’s seniors, their children and their grandchildren.” It is anticipated that the House will again set up to vote on repealing PPACA in the near future.