Rep. Ryan stated that IPAB was effectively unaccountable because its decisions would be almost impossible for Congress to reject or modify. "If IPAB proposes a change in provider payments and Congress doesn't agree with that recommendation, by law our only recourse is to develop another proposal that will save an equal amount of money."
Sebelius noted that while IPAB was tasked by law with "preserving the future of Medicare by making proposals to hold down costs" it would only make proposals if Medicare spending was growing too quickly based on the GDP. She cited a CBO study that projected IPAB would not need to take any action for at least 10 years.
At Wednesday's meeting of the health subcommittee of the House Energy and Commerce Committee Sebelius fielded question after question about the possibility of IPAB reducing provider payments that could result in rationing of services.
"If IPAB decides to reduce provide payments for dialysis is it possible that some providers will stop offering dialysis?" asked subcommittee chairman Joe Pitts (R-Penn). "And won't that limit patient access? That's rationing."