Bill Overview
Title: Patients Before Profits Act of 2022
Description: This bill prohibits a group health insurance plan and a health insurance issuer offering group or individual health insurance coverage from reducing contracted rates or terminating contracts with health care providers during a public health emergency period.
Sponsors: Rep. Porter, Katie [D-CA-45]
Target Audience
Population: People with health insurance and healthcare providers
Estimated Size: 305000000
- The bill affects group health insurance plans and health insurance issuers, implying it involves individuals with health insurance and healthcare providers.
- In the US, a significant portion of the population has health insurance, with around 300 million people having some form of health coverage.
- During public health emergencies like COVID-19, entire populations can be designated as at risk, increasing relevance of such regulations.
- Healthcare providers including doctors, hospitals, and clinics will be directly affected as their contract rates cannot be modified or terminated during emergencies.
- Patients using the services of providers potentially affected by healthcare contract changes will feel impacts directly.
- Those without insurance would not directly be part of the target because the bill targets existing relationships between insurers and providers.
Reasoning
- Since the policy affects a large portion of the U.S. population with health insurance, the impact of this policy is expected to be felt widely. However, the level of impact would vary greatly among different demographics within this group.
- The budget constraints suggest that while many people may experience positive impacts, the intensity and scale may be moderated by financial limits.
- Healthcare providers form a critical part of the healthcare system and would be directly influenced by the policy’s restriction on terminating contracts, which may stabilize their operations during emergencies.
- Patients with ongoing health issues would feel the benefits more than those utilizing healthcare services occasionally.
- The policy's effectiveness relies on its enforcement and the health insurance landscape during emergencies, potentially benefiting or impacting various stakeholders to differing extents.
Simulated Interviews
Nurse Practitioner (Los Angeles, CA)
Age: 45 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- It was frustrating to deal with contract uncertainties during the pandemic.
- This act provides much-needed stability for healthcare providers during emergencies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Software Engineer (Houston, TX)
Age: 32 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- This policy could maintain continuity of care during crises.
- It’s important to have trust that our healthcare system will function properly under pressure.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
General Physician (Chicago, IL)
Age: 50 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- Retaining contract stability would have helped immensely.
- Financial predictability allows better focus on patient care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
Pharmaceutical Sales Representative (New York, NY)
Age: 27 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 4/20
Statement of Opinion:
- I see this act as a safeguard for the healthcare industry's operational stability.
- An important step towards preserving consistent care options.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
IT Specialist (Seattle, WA)
Age: 39 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 5/20
Statement of Opinion:
- Our insurance stability is crucial, and I think any policy that helps enforce that is positive.
- The real test will be in how this is managed during crises.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired (Dallas, TX)
Age: 60 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 10/20
Statement of Opinion:
- This change wouldn’t affect my current insurance much, but I think it’s a good policy.
- Consistency in healthcare is key for people like me with chronic conditions.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Hospital Administrator (Miami, FL)
Age: 52 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 3/20
Statement of Opinion:
- Financial backing through policies would prevent future drastic changes to service provisions.
- It’s comforting to know insurance contracts would hold during uncertain times.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Primary School Teacher (Boston, MA)
Age: 48 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 8/20
Statement of Opinion:
- I value insurance stability for my family’s health.
- Teaching is stressful enough without insurance woes on top of it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Freelancer (San Francisco, CA)
Age: 29 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- Freelancers often face insurance issues due to job changes, more stability is welcomed.
- I think this could be one piece in improving mental health around health security.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
College Student (Austin, TX)
Age: 19 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- I’m not very involved in health insurance decisions yet.
- It sounds like something important for my parents who deal with these things.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Cost Estimates
Year 1: $1750000000 (Low: $1500000000, High: $2000000000)
Year 2: $1750000000 (Low: $1500000000, High: $2000000000)
Year 3: $1800000000 (Low: $1600000000, High: $2100000000)
Year 5: $1900000000 (Low: $1700000000, High: $2200000000)
Year 10: $2200000000 (Low: $2000000000, High: $2400000000)
Year 100: $5000000000 (Low: $4500000000, High: $5500000000)
Key Considerations
- The effect on premium costs for policyholders, as insurers absorb regulatory constraints.
- The healthcare market's response to maintained contractual rates during emergencies, particularly in cost management.
- Potential legal challenges from insurers or providers if they perceive the regulation limits their market freedom.
- Overall financial stability and resilience of healthcare providers during prolonged emergencies.