Bill Overview
Title: John Lewis Equality in Medicare and Medicaid Treatment Act of 2022
Description: 2022 This bill requires the Center for Medicare and Medicaid Innovation to test a payment model that addresses social determinants of health and health disparities, particularly with respect to minorities, underserved areas, and high-risk individuals. The bill also generally incorporates consideration of such factors into the selection, implementation, and evaluation of other models, including the decision as to whether to expand a model's duration and scope.
Sponsors: Rep. Sewell, Terri A. [D-AL-7]
Target Audience
Population: People affected by social determinants of health and health disparities
Estimated Size: 95000000
- The bill focuses on Medicare and Medicaid, which are U.S. federal programs targeting low-income populations and those over 65 or with disabilities.
- As of data around 2021, there were about 63 million people on Medicare and over 80 million on Medicaid in the U.S., with some overlap.
- The bill is particularly concerned with minorities and underserved areas, indicating the impact will be more significant in these demographics.
- Social determinants of health affect a broad range of people, but the model being tested will specifically address high-risk individuals within the Medicare and Medicaid populations.
Reasoning
- The policy is designed to specifically target minorities and underserved areas, so interviews should reflect their perspectives.
- Considering the budget constraints, the policy is likely to affect urban low-income populations where healthcare costs and health disparities are prominent.
- The limitation on high-risk individuals indicates that not every person on Medicare or Medicaid will experience significant change.
- While the initiative may have broader systemic effects, immediate improvements might be more visible in medical and social support within communities most affected by disparities.
- Some individuals, especially those outside the high-risk categories or in well-served areas, may not see any changes, so their baseline and response need to be included.
Simulated Interviews
Retired (Detroit, MI)
Age: 67 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- It's hard to find good doctors in my neighborhood, and we're often the last in line for care.
- If this policy helps more doctors work in my area and understand our needs, that's a good change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Warehouse Worker (Birmingham, AL)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I've been managing my diabetes with the help I can get, but it's not always enough.
- If this policy helps with better access to healthcare services, it would mean I could control my condition better.
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 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired School Teacher (San Diego, CA)
Age: 72 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 3/20
Statement of Opinion:
- I have no issues with my Medicare service, and my needs are always met.
- This policy may not directly impact me, but I hope it helps those who struggle.
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 |
Unemployed (Rural Oklahoma)
Age: 28 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- Healthcare access has always been a struggle for people in my community.
- If this act brings more resources and better care facilities, it would be life-changing for us.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 7 | 4 |
| Year 20 | 8 | 5 |
Taxi Driver (Houston, TX)
Age: 53 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I often feel dismissed in the healthcare system. It's hard to feel like I'm properly looked after.
- Programs to reduce disparities could greatly benefit my community if effectively implemented.
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 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Community Organizer (New York, NY)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- We need more community engagement to address these inequalities in healthcare.
- This policy should emphasize collaboration with local entities to be effective.
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 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Single Mother (Phoenix, AZ)
Age: 39 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- Balancing work and family with limited healthcare is tough.
- Improved services could alleviate some of the burdens on my family.
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 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Retired Army Veteran (Miami, FL)
Age: 76 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 3.0 years
Commonness: 5/20
Statement of Opinion:
- Most of my needs are covered, being a veteran gives me additional support.
- I support policies that help those without as much support as I have.
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 | 8 | 8 |
Construction Worker (Chicago, IL)
Age: 50 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- With my back issues, accessing specialized care has been difficult and costly.
- This bill should facilitate easier access to necessary healthcare.
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 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Tech Consultant (Suburban Pennsylvania)
Age: 30 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 9/20
Statement of Opinion:
- I don't think this policy will affect me directly since I'm not using these services.
- I hope it makes a genuine difference where it's needed.
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: $150000000 (Low: $120000000, High: $180000000)
Year 2: $160000000 (Low: $130000000, High: $190000000)
Year 3: $165000000 (Low: $135000000, High: $195000000)
Year 5: $170000000 (Low: $140000000, High: $200000000)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The bill's emphasis on accounting for social determinants requires significant changes in existing data systems within Medicare and Medicaid.
- The selected models must be evaluated thoroughly to ensure scalability and effectiveness.
- The outcomes of health model testing may extend beyond direct cost savings, influencing policy decisions in healthcare equity.