U.S. Rep. Bruce Westerman (R-AR) introduced H.R. 1332, the Fair Care Act of 2019, in February, and it was referred to the Subcommittee on Military Personnel. Since its introduction, 10 related bills have been offered, most recently on June 21 with H.R. 3379, the Price Relief, Innovation, and Competition for Essential Drugs (PRICED) Act by Rep. Jan Schakowsky (D-IL), which would reduce the patent exclusivity period for biologics from 12 years to five.
The Fair Care Act of 2019 has five sections, including private-sector health insurance reforms to strengthen the Affordable Care Act (ACA) exchanges, lower health insurance premiums, and create an Invisible High-Risk Reinsurance Program (IHRPR). States could participate in a national, federally operated pool or receive a block grant to run their own.
The bill’s Medicare and Medicaid reforms are intended to promote solvency and increase access to quality health insurance. The Food and Drug Administration (FDA) reforms are meant to promote transparency and competition among drug and device manufacturers to increase consumer access to generic products and decrease costs.
Other proposed reforms in the bill aim at increasing competition among hospitals and lowering costs by discouraging monopolies. States could receive grants to eliminate certificate of need or scope of practice restrictions. Or, if a hospital dominates a particular market, it may be required to accept Medicare reimbursement rates from commercial payers.
Some provisions would try to spur innovation and technology by updating patent laws. Other provisions would create more efficient pathways for generic drug development, repeal several Obamacare-era taxes, expand telehealth, reduce spending on Medicare drugs, promote competition among hospitals, and reassign to the states significant decision-making power over health care.
‘Can’t Afford to Wait’
Westerman argues the system urgently needs reform.
“Whether you’re rich or poor, Republican or Democrat, young or old, you are affected in some way by health care,” Westerman said in a press release. “America is blessed with cutting-edge medical technology, researchers and advancements, but we’ve also been fighting over health care for a decade. It’s clear we must address the political gridlock and tension surrounding the health care debates.
“The Fair Care Act covers preexisting conditions, lowers costs and increases consumer choice by incorporating bipartisan proposals, academic research and scientific data,” Westerman stated. “Most importantly, it’s policy that will give Americans fair coverage at a fair price.”
The federal government’s inability to reform its health care laws and regulations is costing people dearly, Westerman says.
“My constituents and Americans across the country are struggling and can’t afford to wait for health care relief any longer,” Westerman stated. “We have little to no control over sudden health issues or preexisting conditions, but we are right to expect access to fair care. I’m excited to begin a national conversation on this issue and look forward to working closely with Congress and the Trump administration to provide the best care for the American people.”
Institute for Policy Innovation Resident Scholar Merrill Matthews says the Fair Care Act addresses problems with Obamacare by implementing provisions conservatives and Republicans have wanted to do for some time, though it falls short of repealing the ACA and thus could impede needed reforms.
“It tries to make it more workable by allowing health insurers to charge younger people less than Obamacare requires, allows states to take a Medicaid block grant, allows physicians to treat poor patients for free in exchange for writing off the cost of care, and many other mostly good steps forward,” said Matthews.
What happens next depends on where the political winds blow, says Mathews.
“If Westerman’s bill were to pass, it might improve Obamacare enough to make it sustainable, even workable,” said Matthews. “The question is whether we should try to save Obamacare or let it die an ignominious death.”
‘An Excellent Alternative’
Washington Policy Center health care policy analyst and retired physician Roger Stark says the high-risk pools in the Fair Care Act would be a good policy.
“High risk pools are an excellent alternative to a preexisting condition mandate for all health insurance policies,” Stark said.
The main issue with high risk pools is the funding mechanism, says Stark.
“Somehow, costs have to be socialized,” said Stark. “The two choices are a small surcharge on all insurance plans or taxpayer funding.” The Fair Care Act leans toward the latter, says Stark.
“Westerman’s bill would place the responsibility on taxpayers,” Stark said. “This is not a bad idea, because by isolating the high-cost, high utilizers of health care, everyone else would see their premiums go down,” said Stark.
The changes to the government’s biggest health care programs would also be good, says Stark.
“His reforms to Medicare and Medicaid would be a good start, such as means-testing seniors for Medicare eligibility or premium copays.”
All told, the Fair Care Act is much better than the current alternatives on offer, says Stark.
“I would love to see all congressional Republicans coalesce around a comprehensive plan such as Rep. Westerman’s,” said Stark. “It would provide an excellent alternative to ‘Medicare for All’ or the incremental march to single-payer via a public option, Medicare buy-in, etc.”
Kenneth Artz ([email protected]) writes from Dallas, Texas.
H.R. 1332, Fair Care Act of 2019, introduced February 25, 2019: https://www.congress.gov/bill/116th-congress/house-bill/1332/actions?q=%7B%22search%22%3A%5B%22fair+care+act%22%5D%7D&r=2
H.R. 3379, Price Relief, Innovation, and Competition for Essential Drugs Act, introduced June 20, 2019: https://www.congress.gov/bill/116th-congress/house-bill/3379
Rep. Bruce Westerman, (R-AR): https://westerman.house.gov
Rep. Janice Schakowsky, (D-IL): https://schakowsky.house.gov