| Plan |
Republican Study Committee Empowering Patients First | |
| Date |
| |
| Overall Approach |
Expanded access to individual coverage through tax incentives, state high risk pools, and other pooling mechanisms | |
| Universal Coverage |
No | |
| Guaranteed Coverage |
No | |
| Portability |
Yes | |
| Voluntary Employer-Based System |
Yes | |
| New Programs |
No | |
| Expansion of Existing Public Programs/Federal Law |
No | |
| Insurance Pool |
Yes:
Provides incentives for states to create high-risk pools
Authorizes non-governmental insurance pooling mechanisms such as association health plans | |
| State Responsibility |
Grants states incentives to establish high-risk / reinsurance pools.
Establishes health plan and provider portals in each state, to supply greater information, rather than acting as a purchasing mechanism.
Requires states tocover 90% of those below 200% of the federal poverty level before they can expand eligibility levels under Medicaid and SCHIP
Provides states with incentives to adopt medical malpractice reforms through the creation of health care tribunals or courts | |
| Individual Mandate |
No | |
| Employer Mandate |
Requires employers to disclose amounts paid for employer-provided health plan coverage | |
| Private Insurance Mandates |
No | |
| Individual Subsidies |
Creates an advanceable, refundable tax credit (on a sliding scale) for low-income individuals to purchase coverage in the non-group / individual market | |
| Individual Vouchers |
Yes - for payment of premiums through the refundable tax credit | |
| Employer Subsidies |
Small businesses are given tax incentives for adoption of auto-enrollment | |
| Individual Plan/Provider Choice |
Gives patients the power to own and control their own health care coverage by allowing for a defined contribution in employer-sponsored plans.
Creates pooling mechanisms, such as association health plans and individual membership accounts.
Allows individuals to shop for health insurance across state lines. | |
| National Health Board |
No | |
| Tax Changes |
Extends the income tax deduction (above the line) on health care premiums to those who purchase coverage in the non-group / individual market.
Provides an advanceable, refundable tax credit (on a sliding scale) for low-income individuals to purchase coverage in the non-group / individual market | |
| Premium/Co-Pay/Deductible |
Not addressed | |
| Health Quality Improvement |
Allows for employers to offer discounts for healthy habits through wellness and prevention programs
| |
| Information Technology / Electronic Medical Records |
Not addressed | |
| Individual Responsibility for Health and Lifestyle |
Not addressed | |
| Preventive care |
Allows for employers to offer discounts for healthy habits through wellness and prevention programs. | |
| Transparency |
Establishes health plan and provider portals in each state, and these portals act to supply greater information, rather than acting as a purchasing mechanism | |
| Drug Reimportation |
Not addressed | |
| Medicare Rx Drug Price Negotiation |
Not addressed | |
| Medical Personnel Education |
Increases funding for Federally Supported Student Loan Funds for primary health care medical students
Provides student loan forgiveness of up to $50,000 for individuals agreeing to work as a primary care provider for at least 5 years | |
| Mental Health Parity |
Not addressed | |
| Other Provisions |
Prohibits the Council for Comparative Effectiveness Research from finalizing recommendations without the consultation and approval of medical specialty societies.
Establishes performance-based quality measures endorsed by the Physician Consortium for Performance Improvement (PCPI) and physician specialty organizations
Reimburses physicians to ensure continuity of care – Rebases the Sustainable Growth Rate (SGR) and establishes two separate conversion factors (baskets) for primary care and all other services
Establishes administrative health care tribunals, also known as health courts, in each state, and adds affirmative defense through provider-established best practice measures. It also encourages the speedy resolution of claims and caps non-economic damages | |
| Cost |
Not yet scored | |
| Cost Containment |
The cost of the plan is completely offset through decreasing defensive medicine, savings from health care efficiencies (reduce DSH payments), ferreting out waste, fraud, and abuse, plus an annual one-percent non-defense discretionary spending step down | |
| Financing |
The cost of the plan is completely offset through decreasing defensive medicine, savings from health care efficiencies (reduce DSH payments), ferreting out waste, fraud, and abuse, plus an annual one-percent non-defense discretionary spending step down | |
| Source |
“Empowering Patients First Act” One – Page Summary, Republican Study Committee, July 30, 2009
Text of Empowering Patients First Act, Library of Congress – Thomas Website, July 30, 2009 | |
