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The Affordable Care Act’s controversial Medicare payment board would be an “agent for reimbursement cuts to Medicare,” according to a policy paper released Wednesday.

Conservative economist Douglas Holtz-Eakin, Ph.D., says the ACA’s Independent Payment Advisory Board shifts Medicare “dangerously close to a rationed system.” Opponents of his views say the law expressly prohibits the panel from changing seniors’ benefits or increasing cost sharing. Earlier this year, House Republicans voted to repeal the IPAB.

Holtz-Eakin, former director of the Congressional Budget Office, argues that the IPAB’s mandate is too narrow. He writes that due to directives and restrictions in the ACA, “reductions achieved by IPAB between 2013 and 2020 are likely to be limited primarily to Medicare Advantage (23% of total Medicare expenditures), to the Part D prescription drug benefit (11%), and to skilled nursing facility services (5%).”

Earlier this week, the Alliance for Quality Nursing Home Care praised an op-ed article co-authored by Holtz-Eakin in Politico. The article noted that the proposed 2% sequestration cuts to Medicare reimbursement would “effectively wipe out” a recent 1.8% payment update to U.S. nursing homes from the Centers for Medicare & Medicaid Services.

“We applaud Douglas Holtz-Eakin and Kenneth Thorpe for not only noting sequestration will decimate the 1.8% SNF CMS update, but they have also helped spotlight how SNF payment cuts can indeed have a negative impact on beneficiaries no matter what anyone says to the contrary,” Alliance President Alan G. Rosenbloom said in a written response to the op-ed.

Click here to read Holtz-Eakin’s policy paper.