Defenders counter that the law bars it from rationing care, restricting benefits or changing eligibility criteria. And, in response to complaints from the health care industry, Sen. John Rockefeller, D-W.Va., who was one of IPAB's architects, said that the board was specifically designed to reduce the influence of "special interests" on Medicare payment policy. Those interests, he and others say, have kept Congress from making the tough decisions needed to hold down spending and reduce the deficit.
How exactly will IPAB slow Medicare spending?
Under the health care law, the board is required to recommend reductions in Medicare if spending per capita is projected to exceed specific targets. From fiscal year 2015 through 2019, that target is based on inflation gauges. Beginning in 2020, the target is based on the growth of the gross domestic product plus one percentage point. Proponents note that IPAB won't impose a "hard cap" on spending, but rather will recommend ways to reduce spending. "IPAB is meant to be a fallback if the health law doesn't control spending as well as we think it will," said Robert Kocher, a former special assistant to Obama on health care.