Bill Overview
Title: HEALTH Act
Description: This bill allows a tax deduction for direct primary care physicians who provide charity care. The care must be provided without expectation of reimbursement and to an individual enrolled in Medicaid or the Children's Health Insurance Program (CHIP). A direct primary care physician is a physician who provides primary care (1) to individuals who have paid a periodic subscription fee, and (2) in exchange for a fee that is published on a publicly available website of the physician.
Sponsors: Rep. Webster, Daniel [R-FL-11]
Target Audience
Population: Individuals enrolled in Medicaid or CHIP
Estimated Size: 88000000
- The beneficiaries of the HEALTH Act will be individuals enrolled in Medicaid or the Children's Health Insurance Program (CHIP).
- Medicaid and CHIP combined serve millions of individuals in the United States, primarily low-income families, children, pregnant women, the elderly, and people with disabilities.
- The act provides a specific incentive for direct primary care physicians to offer charity care to these specific individuals, potentially increasing access to healthcare services for those in need.
Reasoning
- The primary beneficiaries of the HEALTH Act are individuals enrolled in Medicaid or CHIP, including low-income families, children, and individuals with disabilities.
- The policy incentivizes direct primary care physicians to offer charity care, potentially improving healthcare access for these groups.
- Due to the limited budget, only a fraction of the eligible population might benefit in the initial years, especially those who have access to participating direct primary care physicians.
- The impact on wellbeing will vary among individuals depending on their current access to healthcare, geography, and the availability of participating physicians.
Simulated Interviews
unemployed (Albuquerque, NM)
Age: 34 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I'm grateful that more doctors might be available under this policy, as long lines and waiting times have been an issue.
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 | 7 | 4 |
| Year 20 | 6 | 4 |
Part-time driver (Miami, FL)
Age: 45 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- It’s frustrating that some care isn't easily accessible. This policy might help, but I'm concerned about the number of doctors participating.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 4 | 3 |
| Year 20 | 4 | 3 |
Artist (Des Moines, IA)
Age: 29 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- I'm worried about whether there will be enough doctors who understand and are sensitive to issues around queer health.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 2 |
Retired teacher (Seattle, WA)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 8/20
Statement of Opinion:
- Access to primary care for my grandchildren is vital. If this policy helps, I welcome it, but I'm worried about its reach.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Construction worker (Houston, TX)
Age: 51 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 15/20
Statement of Opinion:
- My kid gets coverage through CHIP, and more access to primary care might ease my stress a bit.
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 | 6 | 5 |
| Year 20 | 5 | 4 |
Student (Boise, ID)
Age: 22 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 2.0 years
Commonness: 6/20
Statement of Opinion:
- As someone who's recently out of CHIP, it's good to know more care options are there even if it's now too late for me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 4 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 4 | 3 |
| Year 20 | 4 | 3 |
Barista (Raleigh, NC)
Age: 38 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 16/20
Statement of Opinion:
- Anything that increases my access to doctors is a win, but how quickly this takes effect worries me.
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 | 7 | 5 |
| Year 20 | 6 | 4 |
Disabled veteran (Cleveland, OH)
Age: 50 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 6.0 years
Commonness: 11/20
Statement of Opinion:
- It's challenging managing all our medical needs. More available doctors could mean the world to us.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Freelance writer (Chicago, IL)
Age: 27 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 14/20
Statement of Opinion:
- With a new baby, having more primary care available can only be good.
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 | 6 | 4 |
| Year 20 | 5 | 3 |
Tech support (Portland, OR)
Age: 32 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 9/20
Statement of Opinion:
- It's an innovative idea to get more care from primary doctors, but implementation could be a hurdle.
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 | 7 | 5 |
| Year 20 | 6 | 5 |
Cost Estimates
Year 1: $2000000 (Low: $1000000, High: $5000000)
Year 2: $2500000 (Low: $1500000, High: $6000000)
Year 3: $3000000 (Low: $2000000, High: $7000000)
Year 5: $4000000 (Low: $3000000, High: $9000000)
Year 10: $6000000 (Low: $4000000, High: $12000000)
Year 100: $20000000 (Low: $15000000, High: $35000000)
Key Considerations
- The cost of tax deductions depends heavily on the number of participating physicians and the amount of charity care provided.
- Direct healthcare savings may arise from reduced emergency care demand.
- The long-term impact on public health outcomes and corresponding fiscal cost reductions are uncertain and depend on execution.