By Keegan Gibson, Managing Editor

Rep. Allyson Schwartz, a strong supporter of the Affordable Care Act, has joined Congressional Republicans seeking to repeal a key element of the law.

At issue is the Independent Payment Advisory Board (IPAB), a panel charged with keeping down the costs of federal health programs.

Republicans have IPAB in their sights. Of the 81 cosponsors to the bill to repeal the IPAB, just four are Democrats including Schwartz. Rep. Phil Roe (R-TN), this bill’s sponsor, boasts a 97 percent party loyalty score according to the Washington Post.

Conversely, President Obama has been vocal in his support, even supporting expansions to the panel.

During the debate over health care, Republicans argued that Congress would never have the political will to cut Medicare spending. The IPAB was an important part of Democrats’ counterargument that the health care law would reduce the deficit.

Schwartz (D-Montgomery/Phila) voted for the health care law, but says the IPAB is an illegitimate cession of Congress’s oversight role to unelected bureaucrats.

“Congress is a representative body and must assume responsibility for legislating sound health care policy for Medicare beneficiaries, including those policies related to payment systems,” the Congresswoman wrote in her announcement of cosponsorship. “Abdicating this responsibility, whether to insurance companies or an unelected commission, would undermine our ability to represent the needs of the seniors and disabled in our communities.”

The IPAB is a fifteen member, bi-partisan panel charged with recommending changes to the payment structure of federal health programs. If costs grow faster than certain benchmarks, and Congress fails to implement its own payment plan, the board’s recommendations would take effect without direct Congressional approval.

Supporters, including the Washington Post Editorial Board, say that its an essential cost-cutting measure that takes politics out of the equation.

“Ordinarily, we cheer the increasingly rare occasions when Republicans and Democrats join forces to push legislation. Not this time. The concept behind the IPAB is to bring some intelligent cost-cutting discipline to Medicare reimbursement and insulate payment decisions from politics.”

In either case, cosponsoring H.R. 452 seems like an odd marriage for Schwartz. She was a vocal supporter of the health care reform law, and she has accused the GOP of seeking to end Medicare as we know it. Her position seemed so unlikely to one liberal writer that he suggested the Congresswoman could have a conflict of interest due to her campaign contributions from the health care industry.

“Why does Schwartz want to get rid of IPAB?” wrote Johnathan Cohn of the New Republic. “In a letter announcing her intentions, Schwartz said it was undemocratic to hand over that authority to a commission. And that’s a legitimate (if, in my view, unpersuasive) argument. But a quick look at Schwartz’s campaign finance history, from OpenSecrets.Org, shows that she receives a great deal of support from the health care industry.”

“It’s the health care industry (hospitals, drug makers, insurers) that would feel the brunt of IPAB cost-cutting efforts, since the law prohibits the commission from altering benefits directly or imposing higher financial costs on beneficiaries. Of course, I have no way of knowing how, if at all, donations from such groups influence Schwartz on this matter.”

Since 2004, Schwartz has received $603,179 from health care professionals and PACs. The medical issue group is third in donations to Schwartz, behind the $1.8 million contributed by lawyers and law firms, and the $1.45 million from women’s issues donors. Also relevant to Medicare, Schwartz has received $524,900 from retirees.

Rep. Schwartz flatly rejects the suggestion that her position on the issue is a conflict of interest.

“I have strong relationships with the teaching hospital, the community hospital, researchers, that whole community,” she said.

“I’ve always been absolutely clear that I support legislation based on the issues and the substance. That being said, there are people who support me who agree with me, and there are people who support me who don’t agree with me.”

Schwartz also disagrees that IPAB is an essential element of health care reform. Rather, she says, it is a poorly constructed fail safe that comes last in line among reforms.

“The innovations [of the health care law] themselves will improve quality and outcomes, and reduce costs significantly in Medicare. It is far preferable to reduce costs by improve quality of care and reducing errors rather than reducing reimbursements for providers and hospitals. We’ve been trying that for ten years and it hasn’t worked.”