The CMS Chief Actuary has officially determined that the projected Medicare per capita growth rate will not exceed the target that would require the Independent Payment Advisory Board (IPAB) to submit plans to reduce 2019 Medicare per-capita spending. Under the Affordable Care Act, if the threshold is breached, IPAB must submit detailed Medicare spending cut proposals to Congress and the President; IPAB’s proposals would go into effect automatically unless Congress enacts alternative legislation to achieve the required savings (with certain exceptions).  The IPAB spending control mechanism is deeply unpopular, even though the Board has never been formally constituted nor has the savings target ever been triggered.  There have been numerous legislative attempts to repeal the IPAB authority, and President Trump has called for repeal of IPAB in his FY 2018 budget proposal.