Empower Patients First Act

Rep. Tom Price introduces a new idea for a health care bill that has the potential to be a middle ground in the ongoing reform debate: the Empower Patients First Act, HR 3400.

On the surface, it sounds much more reasonable than HR3200. But I’ve just started to read through the summaries and have yet to get to the actual bill text. And, after this summer, we all know that words are easily manipulated to technically say what people want to hear to gain support, but actually have a completely different meaning underneath and a different result in the long run.

A few ideas I find interesting (keeping in mind that my ultimate support for this bill depends on the details, which I need to read):

1. I don’t hear any mention of a mandate with this bill. Instead, they’re suggesting an automatic enrollment in federal coverage (like Medicaid) with the choice to opt-out. On the surface, I think this is a smart approach to deliver on the “extend coverage to all Americans” promise: people rarely opt-out of things they’re automatically enrolled in. Think about it: you don’t have to do anything, you’re in. It’s on you to take the time and go through the process to unsubscribe. But it’s not mandated coverage. That’s the part I like…you might be enrolled, but you have a choice about whether or not to stay enrolled. Obviously, my support of this option hinges on their definition of “opt-out” and what that process entails, and whether you have the choice to opt-in again if you so desire, and what that means for your existing coverage, etc., etc., but the fact that a choice even exists is a positive step in my opinion.

2. It also provides vouchers to low-income Americans if they want to opt-out of federal coverage and buy their own. Also a nice idea, on the surface. Not sure where the money for the vouchers will come from, but giving low-income people a choice in their coverage as well? I’ll at least give them a point for effort.

3. It will extend tax credits/deductions to people who don’t have coverage through their employer, hopefully making it more affordable for those people who fall through the cracks right now (temporarily unemployed, self-employed and insurance costs too much for their budget but their income disqualifies them for federal programs, etc.) to purchase insurance on their own. I like this idea better than raising taxes on wealthier people to pay for everyone else’s coverage.

4. It allows people to buy insurance across state lines (but there is a stipulation: you can only buy from another state if plans in your state’s premium costs 10% more than the national average…), thus giving people more control over which coverage they want to buy. I think this would be great in terms of competition and provide better prices for premiums, but the stipulation makes me wonder if it would ever be a real possibility. On the flip-side, the stipulation might stimulate enough competition within your own state that crossing lines won’t be necessary because you find great prices at home.

5. There are proposed reforms to medical liability and caps on awards, which would (hopefully) reduce the practice of defensive medicine and thus, drive down some costs.

Again, I have to read the actual bill instead of just the summaries, but this sounds like what should have been proposed in the first place and then been subjected to negotiations and amendments and such. I’m not sure how the Republicans have proposed to pay for this plan, or whether it addresses other concerns– like federally funded abortions, HSAs, end-of-life procedures, what it means for small businesses, etc.–but it’s a much more “competitive” approach that gives more power and choice to the people and the market (instead of a committee of beaurocrats) than I’ve seen so far.

So, who knows? I, for one, am just glad to see another option on the table, instead of just status quo or HR 3200. And I’m glad to see the Republicans putting up instead of just shutting up. It’s starting to feel like an actual conversation now instead of a one-sided, elitist contempt-fest.

You can read about HR 3400 here and here, and the actual bill here (there’s a link to the full text at the bottom of the page).


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