The House Ways and Means Committee has approved by a 24-13 vote HR 849, Protecting Seniors’ Access to Medicare Act, to repeal the Independent Payment Advisory Board (IPAB). The IPAB was established by the ACA to submit Medicare spending plans to Congress if projected spending growth exceeds specified targets. Under the ACA, future IPAB’s proposals would go into effect automatically unless Congress enacts alternative legislation achieving required savings levels. IPAB members have not been appointed, and the spending threshold has not yet been crossed. President Trump called for repeal of IPAB in his FY 2018 budget proposal, but opponents cite the bill’s estimated $17.5 billion/10 year cost. The legislation has not yet been considered by the full House.