Paul Ryan likened a mechanism to control health care spending to “death panels,” during a town hall at the University of Central Florida in Orlando on Saturday.

After listening to Ryan repeatedly call for the repeal of the Affordable Care Act, an elderly man asked the Republican vice presidential nominee about “the death panels.” Rather than dissuading the man from what PolitiFact named 2009’s Lie of the Year, Ryan laughed and responded, “that’s not the word I’d choose to use to describe it. It’s actually called….the Independent Payment Advisory Board”:

QUESTION: We love you Paul. But I’m getting long in years. Will you address the death panels that we’re going to have?

RYAN: The death panels, well! That’s not the word I’d choose to use to describe it. It’s actually called. It’s actually called, so in Medicare, what I refer to as this board of 15 bureaucrats. It’s called the Independent Payment Advisory Board. It sounds fairly innocuous.

Watch it:

The Board, or IPAB — a provision included in the Affordable Care Act — is tasked with making binding recommendations to Congress for lowering health care spending, should Medicare costs exceed a target growth rate. Congress can accept the savings proposal or implement its own ideas through a super majority.


The panel’s plan will modify payments to providers but despite Ryan’s claims, it cannot “include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums…increase Medicare beneficiary cost-sharing (including deductibles, coinsurance, and co- payments), or otherwise restrict benefits or modify eligibility criteria” (Section 3403 of the ACA). The IPAB will consist of 15 members appointed by the president and confirmed by the Senate, and will include a broad spectrum of experts and consumer advocates, like physicians, employers, economists, representatives of consumers and the elderly. In fact, relying on health care experts rather than politicians to control health care costs has previously attracted bipartisan support and even Ryan himself proposed two IPAB-like structures in a 2009 health plan.