Mr. Speaker, I thank my friend for yielding me this time. Mr. Speaker, I rise today in opposition of the repeal of the Independent Payment Advisory Board. This is another classic example of a solution in search of a problem. Of all the…
Mr. Speaker, I thank my friend for yielding me this time.
Mr. Speaker, I rise today in opposition of the repeal of the Independent Payment Advisory Board.
This is another classic example of a solution in search of a problem. Of all the things that we should be working on in Congress in a bipartisan fashion to improve and to fix the problems that exist within our healthcare system, we have legislation on the floor before us today that calls for the repeal of a nonexisting commission, based on nonconsistent spending cuts being proposed for Medicare, based on a nonconsistent cost of rate of increase in spending under the Medicare program, all of which is going to add $17.5 billion to the deficit over the next 10 years because this bill isn't paid for. And the irony is they are coming forward with this legislation, which will add another $18 billion to the debt, on the same day they release a tax bill that calls for an additional $1.5 trillion worth of deficit spending because the tax bill hasn't been offset. At some point and at some time, we have got to take a bipartisan stand on fiscal responsibility in this place again because it is not happening today.
Instead, we should be working on short-term, practical solutions to stabilize and bring more certainty to the health insurance marketplace, in light of what the administration is doing to completely undermine the marketplaces today. We ought to be working on delivery system reform proposals that will emphasize the establishment of accountable care organizations and medical homes and value-based purchasing and bundling arrangements and different alternative payment models to get us to a system of value, quality, and outcomes, and away from the fee- for-service payment for the volume of services, regardless of results.
Let's be honest, the real cost driver in our Federal budget--and it is true at the State and local level--has been healthcare costs because we have an aging population. That is the work that we should be working on together, is the delivery system reform and the payment reform, so we are aligning the incentives in the right direction where we are telling our healthcare providers: You will be compensated based on good results, not on how much you do.
There is a lot within the Affordable Care Act giving our providers the very tools in order to accomplish that, and we ought to be enhancing that here today. Instead, we are wasting time on a commission that, according to the CMS's own actuary, says, at the very earliest, it might be comprised in 2021. But, even then, it warrants us, with the mission that we have given it, that: Hey, you have got healthcare spending within the healthcare system that, Congress, you need to deal with. And then come back with recommendations. And then it is up to us to make corrective action at that time.
So all this talk about unelected bureaucrats making these decisions belies what the legislation actually calls for in the establishment of the IPAB. This was, however, another important cost containment tool that was put into the Affordable Care Act to try to restrain the growth of healthcare spending. We need more of those type of ideas, rather than efforts today to remove those tools and then possibly see just unbridled healthcare spending in the future.
What is really disturbing is I know there is a lot of common ground in this area, yet the American people wouldn't know it, with this political ping-pong ball on healthcare reform going back and forth and the chaos and the confusion that it is causing, and that is unfortunate.
So, instead, today, we ought to first take steps to stabilize the insurance exchanges, rather than an administration that is doing everything they can to limit the enrollment during the signup period, which actually started yesterday and lasts until December 15. They have cut by 90 percent funding for marketing of the exchanges. They have cut by almost 50 percent the funding for our navigators back home who are trying to help people get affordable healthcare coverage in their lives. They ended the cost-share payments, which only increases the cost for healthcare for everyone else because of the risk that the insurance plans now face.
The other segment of the population that we should be focused on in helping is that 5 or 6 percent of the population that are in the individual market who don't qualify for premium tax credits because they are getting hammered today. You would think that would be another area of bipartisan commonality that we can come together on
to provide relief for those individuals who are in the individual market experiencing these higher premiums, part of it being done because of the elimination of the cost-sharing reduction payments, but, instead, nothing is being done on that front.
My friend from Michigan also pointed out that we should be having hearings about the cost of prescription drugs in committee. That is one of the main cost drivers within the healthcare system, yet there is deafening silence in the Halls of Congress when it comes to taking measure on that front, even though President Trump promised during the course of his campaign and even earlier this year to try to take some action in a bipartisan way to address drug costs.
It was an initiative that the President was even interested in trying to address. Yet, again, nothing is being done.
So this legislation is much ado about nothing because there is nothing pending. In fact, nothing would be pending, according to the CMS actuary, until, at the earliest, 2021. Instead, we are wasting time and opportunity to address the real problems and finding the real fixes that are needed in the healthcare system. There I am confident there is a lot of bipartisan overlap, having worked with many of my colleagues on the committee and across the aisle, on many of these measures that I just mentioned here today.
So I encourage my colleagues to vote ``no'' and allow this to go forward, because it does keep an eye on rising costs and it keeps the pressure where it belongs--right here in Congress--to take future action if the rate of growth starts spinning out of control.