Bill Overview
Title: Protecting Health Care for All Patients Act of 2022
Description: This bill prohibits all federal health care programs, including the Federal Employees Health Benefits Program, and federally-funded state health care programs (e.g., Medicaid) from using prices that are based on quality-adjusted life years (i.e., measures that discount the value of a life based on disability) to determine relevant thresholds for coverage, reimbursements, or incentive programs.
Sponsors: Rep. McMorris Rodgers, Cathy [R-WA-5]
Target Audience
Population: People who rely on federal or federally-funded state health care programs
Estimated Size: 100000000
- The bill affects all federal healthcare programs and federally-funded state healthcare programs.
- Use of QALYs and measures that discount based on disability is common in many healthcare assessments and cost-effectiveness analyses.
- Any patient under these programs could potentially be impacted by changes in how coverage and reimbursements are calculated.
Reasoning
- The policy targets a broad spectrum of patients who utilize federal and state health care programs. These range from people dependent on Medicaid, to federal employees benefiting from the Federal Employees Health Benefits Program, among others.
- The impact on individuals will vary significantly depending on their reliance on low-cost, subsidized healthcare due to disabilities, chronic illnesses, or acute conditions.
- There is potential for improved access to healthcare for those with disabilities since the policy could lead to non-discrimination in healthcare value assessments based on quality-adjusted life years (QALYs).
- Given the large population potentially affected and the diversity of cases within this population, one can expect a wide range of reactions and impacts.
- Consideration was given to cover urban vs. rural settings, different ages, and individuals with different roles in the healthcare system.
- The budget allowances mean that the policy needs to be cost-effective, potentially prioritizing large impact individuals or systemic changes rather than minor, more expensive adjustments.
Simulated Interviews
Retired (Tucson, AZ)
Age: 70 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 15/20
Statement of Opinion:
- I think it's good that this policy could stop devaluing lives of people like me with disabilities.
- Healthcare should be more accessible and valuing everyone's life the same seems fair to me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 4 |
Software Developer (Boston, MA)
Age: 48 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I've never heard of QALYs affecting my healthcare, so maybe it won't change a lot for me personally.
- I hope this policy makes things better for more vulnerable folks.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 7 |
Stay-at-home parent (Chicago, IL)
Age: 34 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 14/20
Statement of Opinion:
- For me, anything that makes Medicaid better and fairer for my kids and me is welcome.
- I worry about how much money really goes to changes like these, though.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Farmer (Rural Texas)
Age: 59 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Healthcare in rural areas is already tricky.
- I'd hope this change means more options for someone like me who relies on government healthcare.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
Graduate Student (Atlanta, GA)
Age: 28 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- Accessibility to mental health resources without discrimination is crucial to my wellbeing.
- I believe this is a step in the right direction for comprehensive healthcare support.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Retired healthcare worker (Miami, FL)
Age: 65 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 12.0 years
Commonness: 13/20
Statement of Opinion:
- Healthcare costs are a huge stressor for seniors.
- This policy sounds good, but I worry it won't make as big of a difference as it promises.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 3 |
Self-employed (San Francisco, CA)
Age: 52 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- I like the idea of healthcare not discriminating against pre-existing conditions.
- Wide-reaching policies can sometimes waste funds, though.
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 | 6 |
| Year 20 | 6 | 6 |
Entry-level healthcare worker (New York, NY)
Age: 23 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 17/20
Statement of Opinion:
- Hopefully, this policy leads to better support for younger folks starting out.
- Affordability of necessary treatments should improve without complicated metrics I'm not sure I understand.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 4 |
Hospital administrative staff (Philadelphia, PA)
Age: 45 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- In my line of work, I see how policy changes can critically impact patient access.
- This policy could be a game-changer in making sure everyone gets the same chance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 5 |
Stay-at-home parent (Los Angeles, CA)
Age: 39 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 16/20
Statement of Opinion:
- Anything that supports my child getting fair healthcare is important to our family.
- I worry about the real-world application of such policies.
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 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 4 |
Cost Estimates
Year 1: $2000000000 (Low: $1700000000, High: $2300000000)
Year 2: $2100000000 (Low: $1800000000, High: $2400000000)
Year 3: $2200000000 (Low: $1900000000, High: $2500000000)
Year 5: $2400000000 (Low: $2000000000, High: $2700000000)
Year 10: $2800000000 (Low: $2300000000, High: $3300000000)
Year 100: $5000000000 (Low: $4000000000, High: $6000000000)
Key Considerations
- The change from current measures to alternative valuation metrics may require extensive retraining and adjustment for healthcare administrators and professionals.
- Socioeconomic disparities could widen as the spending capacity of government healthcare programs might be stretched.
- Potential increases in healthcare premiums or out-of-pocket expenses for individuals not directly covered may arise if federal programs attempt cost mitigation.