Bill Overview
Title: Helping Families Access Pediatric Care Act of 2022
Description: 2 This bill prohibits deductibles for outpatient pediatric services under private health insurance, Medicaid, the Children's Health Insurance Program (CHIP), and TRICARE.
Sponsors: Rep. Schrier, Kim [D-WA-8]
Target Audience
Population: Individuals reliant on insurance systems for outpatient pediatric services
Estimated Size: 73000000
- The bill impacts all individuals who are reliant on insurance systems that typically bill for outpatient pediatric services.
- It will affect those using private health insurance, Medicaid, CHIP, and TRICARE which cover a significant portion of pediatric healthcare coverage.
- The legislation's focus on deductibles for outpatient pediatric services means it will particularly affect families with children.
Reasoning
- The Helping Families Access Pediatric Care Act of 2022 targets a substantial portion of the U.S. population, focusing on families with children who require outpatient pediatric services.
- According to the U.S. Census Bureau, there are about 73.1 million children in the U.S., many of whom are covered by private health insurance, Medicaid, CHIP, or TRICARE.
- The prohibition of deductibles will directly impact these families by potentially reducing their out-of-pocket costs for necessary pediatric care.
- With a budget of $2.5 billion for the first year and $28.9 billion over ten years, the policy should sustainably support the removal of deductibles for a large number of families.
- We need to ensure that while the budget is substantial, it aligns with the expected costs and distribution across the multiple programs outlined.
- This simulation also considers people who may not be directly impacted due to different insurance plans or lack of deductible expenses.
Simulated Interviews
Teacher (Houston, TX)
Age: 35 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- The removal of deductibles could ease our monthly budgeting.
- Currently, deductible payments are a significant concern for our family's finances.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 4 |
| Year 20 | 8 | 4 |
Electrician (Phoenix, AZ)
Age: 42 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Every bit of savings helps, and removing deductibles is a big deal.
- This policy means I won’t have to worry as much about unexpected medical costs for my kids.
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 | 7 | 4 |
| Year 20 | 7 | 4 |
Software Developer (Chicago, IL)
Age: 29 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- The ease in financial strain will be beneficial, though we don't frequently hit the deductible.
- I appreciate the effort to lessen healthcare costs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 7 |
Small Business Owner (Miami, FL)
Age: 50 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 2.0 years
Commonness: 8/20
Statement of Opinion:
- This policy seems useful, but my family already has a good insurance plan.
- I'm more concerned about premiums rising in the future.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Barista (Seattle, WA)
Age: 24 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I'm glad my sibling will have less financial burden for healthcare expenses.
- Though it doesn't directly affect me, it indirectly benefits my family relationships.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Nurse (Boston, MA)
Age: 37 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- The overall financial relief is good, especially in current economic conditions.
- I hope this brings attention to other healthcare cost issues as well.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 5 |
Unemployed (Denver, CO)
Age: 31 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- Anything that reduces costs is very needed right now.
- I'm relieved to hear about the reduced burden of deductibles.
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 | 3 |
| Year 20 | 8 | 3 |
Freelance Writer (Los Angeles, CA)
Age: 30 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- The policy is a step forward, but insurance premiums are still a major expense.
- I'm cautious about how it affects the overall healthcare system.
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 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
Construction Worker (Atlanta, GA)
Age: 26 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 7.0 years
Commonness: 7/20
Statement of Opinion:
- With our first baby on the way, this is one less thing to worry about.
- I feel more secure about future kids' healthcare needs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 9 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Corporate Lawyer (New York, NY)
Age: 45 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 3/20
Statement of Opinion:
- Our coverage is already comprehensive, so this policy won't affect us.
- Others might benefit more, which is okay.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Cost Estimates
Year 1: $2500000000 (Low: $2000000000, High: $3000000000)
Year 2: $2600000000 (Low: $2100000000, High: $3100000000)
Year 3: $2700000000 (Low: $2200000000, High: $3200000000)
Year 5: $2900000000 (Low: $2400000000, High: $3400000000)
Year 10: $3200000000 (Low: $2700000000, High: $3700000000)
Year 100: $5000000000 (Low: $4200000000, High: $5800000000)
Key Considerations
- The impact on insurance premiums could be counter-productive if insurers raise premiums to offset their increased costs due to the prohibition on deductibles.
- Monitoring utilization rates will be critical to manage potential cost increases in healthcare services.
- The potential for preventive care to reduce future medical costs, though not immediately evident, should be considered in long-term health economic evaluations.