Debate of health care law grows louder as anniversary, court date near

By Karoun Demirjian

Thursday, March 22, 2012 | 7:06 p.m.

WASHINGTON - To mark the two-year anniversary of the new health care law, House Republicans took another stab at repealing it Thursday, passing a bill to liquidate the Independent Payment Advisory Board, or IPAB, the panel set up under the law to keep Medicare costs low.

The legislation is unlikely to proceed through Congress, where Nevada Sen. Harry Reid has deftly staged end-runs around most attempts to undo provisions of 2010’s Affordable Care Act. But it’s an opportunity for Republicans to raise a battle cry before the legal challenge of the law heads to the Supreme Court next week.

In Nevada, the loudest cry is being raised by Sen. Dean Heller’s campaign against his main 2012 opponent, Rep. Shelley Berkley.

“Just yesterday, Shelley Berkley campaigned on the House floor, touting her support for seniors’ health care. Today, she turned around and voted to deny health care for seniors,” said Heller campaign spokeswoman Chandler Smith. “Her hypocrisy on this issue is misleading and dangerous.”

Medicare is the central political sticking point in the fight over the president’s health care overhaul and efforts to repeal it, such as today’s bill to dismantle the IPAB, and this week’s roll-out of the House budget -- the legislation Berkley was discussing Wednesday on the House floor.

But even within the confines of the IPAB bill there’s a problem, at least of perception, for Berkley in this vote.

For the last year, she has been one of the most outspoken Democratic critics of the IPAB, calling for the repeal of the board, and even co-sponsoring a previous iteration of the repeal bill that passed the House today.

The panel, which would be made up of 15 members appointed by the president, would have quasi-legislative power to mandate reductions to Medicare spending if it starts to exceed certain targets. In fact, the only thing that could stymie an IPAB ruling is if Congress got together to actively vote down the new rule.

The fear is that if the IPAB orders the government to reduce Medicare payments, it could cause a sharp drop in the availability of services, as doctors might refuse to see Medicare patients they have previously covered, leading to rationed care for seniors.

While Berkley has said she trusts the president to fashion a panel of experts that would not issue such recommendations, she doesn’t believe that as a matter of course, Congress should be cut out of the equation.

But when push came to shove, she wouldn’t vote to get rid of the panel.

“I cannot support this measure because it includes a politically motivated poison pill that undermines basic protections for patients across the country,” Berkley said in a statement after the vote.

What she’s referring to is a provision that was worked into the bill to limit the amount of medical malpractice awards -- a change that cost Democratic support. In the end, only 7 joined all but 10 Republicans in the House to vote for its passage.

While the idea of a cap on damages that could be awarded to a medical patient turned off some lawmakers, it was championed by others.

Nevada Rep. Joe Heck, a doctor, called the limitations to malpractice awards “meaningful medical liability reforms” and a “common sense change [that] will also help ensure access to health care and halt the expensive practice of defensive medicine.”

Heck voted for the legislation, as did Nevada Rep. Mark Amodei, both Republicans.

Berkley’s no vote -- despite many months calling for an IPAB ouster -- leaves her open to political attacks.

Shortly following the vote, Heller -- who didn’t vote on the measure and probably won’t -- issued a news release through his campaign casting Berkley’s vote as the latest in a string “to put the government between seniors and their doctors.”

The march of votes they refer to includes Berkley’s support for the president’s health care bill, her unwillingness to repeal the whole thing, and her support for last summer’s debt ceiling compromise as evidence of their assertion. Heller took opposite votes on all those bills, and still consistently calls for the repeal of the national health care law.

Berkley counters that it’s lawmakers with voting records like Heller’s who are jeopardizing Medicare and clouding the political message.

“I continue to believe that Congress is better equipped to address patient care than the Independent Payment Advisory Board, but I do reject the over-the-top attacks by some Washington Republicans against proponents of the Board. The only ones trying to cut Medicare benefits are those who voted for the Ryan Budget.”