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June 18, 2015 01:00 AM

House votes to kill medical-device tax; IPAB repeal delayed

Steven Ross Johnson
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    (Story updated at 3:10 p.m. ET.)

    President Barack Obama has threatened to veto a repeal of the medical-device tax, primarily on the grounds that the legislation does not identify an alternative revenue source to offset the loss of $29 billion through 2022. Despite having bipartisan support in both the House and the Senate, supporters of the tax repeal are unlikely to get enough votes to override a presidential veto.

    The vote comes as the U.S. Supreme Court is expected in a matter of days to issue its ruling in the King v. Burwell case. About 6.4 million people in up to 37 states could be in jeopardy of losing their health premium subsidies if the court rules in favor of the plaintiff, making health plans unaffordable for many low-income individuals.

    Lawmakers postponed final passage of the proposed Protecting Seniors' Access to Medicare Act despite a majority voting in favor of the bill. The measure would repeal the Independent Payment Advisory Board, a 15-member body of outside experts established by the Affordable Care Act to propose recommendations to control Medicare spending growth.

    Supporters of repealing the IPAB contend the panel could have the ability to unilaterally (and without congressional input) make cost decisions that could negatively affect the care of patients .

    “This is an agency that I believe should not exist and does not follow our democratic ideals,” said Rep. Paul Ryan (R-Wis.) during debate.

    Defenders of the IPAB argued that calls for repeal were just an attempt by ACA foes to further gut the healthcare law, citing the more than 50 votes that have taken place to repeal all or parts of the ACA since 2011.

    House and Senate Republican leaders briefed rank-and-file GOP lawmakers on Wednesday about their plans should the court annul many of the subsidies, which are a cornerstone of the ACA. With Republicans running Congress, most want to find a way to avoid being blamed for causing such problems and antagonizing voters.

    Under the tentative House GOP proposal, the subsidies would continue for a year.

    Then, states could design their own plans for funneling federal health dollars to residents and drop the health law's consumer protections, such as guaranteeing that family policies cover children until age 26.

    In 2017—when Republicans hope to control the White House—the ACA would be eliminated.

    The Senate GOP plan, which could change, would continue federal aid for people who lost subsidies until after the 2016 elections, said a chief author, Sen. John Barrasso (R-Wyo.).

    Like the House plan, it would erase the mandates for individual and employer-provided coverage. Democrats say without those requirements, the healthcare law would not function properly because too many people would be uncovered.

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