The budget deal in Congress is billed as a measure to grant stability to a government funding process that has lurched from crisis to crisis — but it is also stuffed with provisions that will broadly affect the nation’s health care system, like repealing an advisory board to curb Medicare spending and funding community health centers.
Many of the provisions have been in gestation for months, even years in some cases. Some will save money. Many will cost money — potentially a lot of money.
Among the more significant provisions is one that would eliminate a powerful 15-member panel, known as the Independent Payment Advisory Board, created by the Affordable Care Act to control the rising costs of Medicare.
President Barack Obama and his first budget director, Peter R. Orszag, as well as some health economists, championed the board as one of the most significant cost-control provisions in the 2010 health law. The board was to recommend specific savings if Medicare spending per beneficiary was projected to grow faster than certain benchmarks. Congress could have stepped in to block the recommendations, but they did not need congressional approval to take effect.