The House Energy and Commerce and Ways and Means Committees have approved H.R. 452, the Medicare Decisions Accountability Act of 2011, which would repeal the ACA’s controversial Independent Payment Advisory Board (IPAB). IPAB is charged with submitting detailed proposals to Congress and the President to reduce Medicare per-capita spending if projected spending growth exceeds a specified target based initially on inflation and then growth in the economy. IPAB’s proposals will go into effect automatically unless Congress enacts alternative legislation to achieve the required savings (with certain exceptions). The legislation now awaits consideration by the full House. Note that Congressional Budget Office (CBO) estimates that repealing the IPAB would increase Medicare spending by $3.1 billion over the 2013-2022 period. While the CBO warns that its estimate is “extremely uncertain because it is not clear whether the mechanism for spending reductions under the IPAB authority will be triggered under current law over the next 10 years,” the cost associated with legislation could complicate repeal efforts. The White House has yet to name any members (which require Senate approval) to the Board.