Cost-cut­ting board in GOP sights

2 Democrats join sub­com­mit­tee vote to elim­i­nate it

The Washington Times Daily - - Politics - BY PAIGE WIN­FIELD CUN­NING­HAM

Af­ter vot­ing last fall to scrap a longterm care pro­gram in Pres­i­dent Obama’s health care law, House Repub­li­cans homed in Wed­nes­day on their next ma­jor tar­get in the law by ad­vanc­ing leg­is­la­tion that would repeal a Medi­care cost-cut­ting panel and win­ning sup­port for the move from a lead­ing Demo­crat.

Rep. Frank Pal­lone Jr., rank­ing mem­ber of the En­ergy and Com­merce Com­mit­tee’s health sub­com­mit­tee, has long agreed with Repub­li­cans who want to repeal the In­de­pen­dent Pay­ment Ad­vi­sory Board (IPAB), a panel charged with curb­ing ris­ing Medi­care costs that GOP law­mak­ers charge could limit op­tions for se­niors by low­er­ing pay­ments made to Medi­care doc­tors.

Repub­li­cans are try­ing to frame the is­sue as an in­dict­ment of Pres­i­dent Obama’s en­tire health care over­haul, leav­ing Democrats such as Mr. Pal­lone in the del­i­cate po­si­tion of ex­plain­ing their op­po­si­tion to the panel while sup­port­ing the bulk of Mr. Obama’s health care law.

“Let me be very clear,” said New Jer­sey’s Mr. Pal­lone. “My vote in sup­port of abol­ish­ing IPAB is not re­lated to my sup­port for the Af­ford­able Care Act. In fact, I do not see IPAB as a sig­nif­i­cant fac­tor in the Af­ford­able Care Act.”

Joined by Mr. Pal­lone and Rep. Edol­phus Towns, New York Demo­crat, Repub­li­cans voted 17-5 to send the bill be­fore full com­mit­tee — a sig­nal that re­peal­ing IPAB is a top GOP pri­or­ity.

Mr. Pal­lone said he op­poses the panel be­cause it po­ten­tially could un­der­mine Congress’ au­thor­ity by al­low­ing 15 med­i­cal ex­perts ap­pointed by the pres­i­dent to rec­om­mend cuts in provider pay­ments if Medi­care costs grow faster than a tar­geted rate.

Repub­li­cans, on the other hand, are mo­tived by an un­der­ly­ing de­sire to un­der­mine Mr. Obama’s health care law, he said.

“This is an ef­fort by the other side to con­tinue its po­lit­i­cal game of de­fac­ing the Af­ford­able Care Act,” Mr. Pal­lone said. “All the Repub­li­cans want to do is repeal the Af­ford­able Care Act piece by piece. And to­day is sim­ply an­other at­tempt at those ef­forts.”

But Repub­li­cans have is­sued the same crit­i­cisms.

“It is merely an­other ex­am­ple of valu­ing cen­tral­ized decision-mak­ing by gov­ern­ment-ap­pointed ex­perts over judg­ments that should be made be­tween doc­tor and pa­tient,” said health sub­com­mit­tee Chair­man Joseph R. Pitts, Penn­syl­va­nia Re­pub­li­can.

Democrats in­di­cated they were split over the is­sue last sum­mer when Repub­li­cans held two con­gres­sional hear­ings to at­tack the IPAB, with Mr. Pal­lone say­ing at the time that he would vote to repeal it.

The panel would be banned from mak­ing any rec­om­men­da­tions to cut ben­e­fits, raise pre­mi­ums, al­ter el­i­gi­bil­ity or ra­tion care. While a sim­ple ma­jor­ity in Congress could rec­om­mend its own sav­ings, it would re­quire a su­per­ma­jor­ity to block the panel’s rec­om­men­da­tions.

The law leaves the panel with few op­tions for cut­ting costs ex­cept by re­duc­ing provider pay­ments and gives un­elected ap­pointees too much power, op­po­nents charge.

Pres­i­dent Obama said Wed­nes­day his apol­ogy to Afghan Pres­i­dent Hamid Karzai for the burn­ing of Ko­rans by U.S. troops last week has “calmed things down” af­ter the episode spawned waves of vi­o­lent anti-amer­i­can protests.

“We’re not out of the woods yet,” Mr. Obama told ABC News in an in­ter­view at the White House. “But my cri­te­ria in any decision I make, get­ting rec­om­men­da­tions from folks who are ac­tu­ally on the ground, is what is go­ing to best pro­tect our folks and make sure that they can ac­com­plish their mis­sion.”

Mr. Obama’s let­ter to Mr. Karzai expressed his ad­min­is­tra­tionęs “re­gret and apolo­gies over the in­ci­dent in which re­li­gious ma­te­ri­als were un­in­ten­tion­ally mis­han­dled,” a White House spokesman said last week.

Mr. Karzai’s of­fice said Mr. Obama called the Ko­ran burn­ings “in­ad­ver­tent,” adding that the U.S. “will take the ap­pro­pri­ate steps to avoid any re­cur­rence, to in­clude hold­ing ac­count­able those re­spon­si­ble.”

The pres­i­dent’s crit­ics and some mem­bers of the mil­i­tary have ques­tioned the ap­pro­pri­ate­ness of the apol­ogy, given the sub­se­quent killing of two U.S. mil­i­tary of­fi­cers at the hands of an Afghan in­side one of the cap­i­tal’s se­cure min­istry build­ings.

For­mer House speaker Newt Gin­grich, a GOP can­di­date for pres­i­dent, crit­i­cized Mr. Obama for “sur­ren­der­ing.”

“The pres­i­dent apol­o­gized for the burn­ing, but I haven’t seen the gov­ern­ment de­mand that the gov­ern­ment of Afghanistan apol­o­gize for the killing of two young Amer­i­cans,” Mr. Gin­grich said. “He is con­sis­tently apol­o­giz­ing to peo­ple who do not de­serve the apol­ogy of the United States. Pe­riod.”

But the pres­i­dent told Bob Woodruff of ABC News that he has no sec­ond thoughts about the apol­ogy.

“Ev­ery­thing else — the pol­i­tics or sec­ond guess­ing of these var­i­ous de­ci­sions — I’m not wor­ried about,” Mr. Obama said.

In the in­ter­view, the pres­i­dent tried to smooth over the re­cent ten­sions be­tween Afghan and U.S. forces as his ad­min­is­tra­tion pre­pares for the even­tual with­drawal of all troops by the end of 2014.

“As dif­fi­cult as Afghanistan has been, we are mak­ing progress be­cause of the ex­tra­or­di­nary ser­vice of our men and women in uni­form,” the pres­i­dent said. “The over­whelm­ing ma­jor­ity of Afghan troops have wel­comed and ben­e­fited from the train­ing and part­ner­ing that we’re do­ing.”

He said war is “tough busi­ness” and rarely goes per­fectly.

“When you think about it, the same thing was true in Iraq,” he said. “But be­cause of the stick-to-it­ness of our teams, I feel con­fi­dent that we can stay on a path that by the end of 2014 our troops will be out and will not be in a combat role and Afghans will have ca­pac­ity, just as Iraqis, to se­cure their own coun­try.”

Mr. Obama and first lady Michelle Obama were host­ing a din­ner at the White House Thurs­day night for troops who served in the Iraq War. The evening has the theme, “A Na­tion’s Grat­i­tude.”

Ear­lier Wed­nes­day, Mr. Obama hosted a White House meet­ing with con­gres­sional lead­ers of both par­ties, a lun­cheon that pro­duced pos­i­tive com­ments — as well as more elec­tion-year snip­ing about gas prices.

The sub­ject of the pri­vate lunch in the West Wing was jobs, and White House press sec­re­tary Jay Car­ney said Mr. Obama emerged hopeful that he can strike some leg­isla­tive deals with con­gres­sional Repub­li­cans to boost the econ­omy.

“It was a con­struc­tive and cor­dial meet­ing,” Mr. Car­ney said. “If folks fo­cus on the ar­eas of agree­ment and work in a co­op­er­a­tive, bi­par­ti­san fash­ion, we can ad­vance the Amer­i­can peo­ple’s agenda.”

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