Bill Overview
Title: Affordable Rabies Treatment for Uninsured Act
Description: This bill requires the Department of Health and Human Services to establish a program to reimburse health care providers that furnish postexposure rabies treatments to uninsured individuals.
Sponsors: Rep. Bera, Ami [D-CA-7]
Target Audience
Population: Uninsured individuals who may need rabies postexposure treatment
Estimated Size: 5000000
- Rabies is a viral disease that is typically fatal once symptoms appear, making postexposure prophylaxis (PEP) crucial.
- PEP for rabies consists of a series of injections that are costly, especially without insurance coverage.
- According to the World Health Organization, rabies exposures occur often, with an estimated tens of millions of exposures worldwide each year.
- Uninsured individuals are typically less likely to seek and receive adequate postexposure treatment due to its high costs.
- Approximately 3-4 billion people live in areas of the world where dog rabies still exists.
- Uninsured populations are more vulnerable to high healthcare costs and financial barriers.
Reasoning
- This policy is aimed primarily at uninsured individuals who require postexposure prophylaxis (PEP) for rabies, a treatment that is typically expensive without insurance. The budget allocations suggest it can cover a substantial number of individuals, but given the nature of rabies PEP costs, the reach might be limited to certain high-risk groups or locations.
- In constructing this simulation, we need to consider diversity in demographics to reflect the uninsured population in the U.S., such as variations in age, gender, and occupational risks (like agriculture or veterinary work). The location will also play a key role, as rural areas might see more wildlife and stray animals, potentially increasing the risk.
- We must account for people who may be indirectly affected by the policy via reduced financial stress for healthcare providers or community awareness. This makes it necessary to include a variety of perspectives ranging from high impact to no impact.
- The scenarios should also reflect differing levels of healthcare access and financial situations, i.e., those completely without access and those with some alternative routes to acquiring PEP.
- Lastly, the simulated responses should indicate changes in perceived wellbeing, considering both direct health outcomes and broader financial implications, especially in a scenario without policy intervention.
Simulated Interviews
farm worker (rural Ohio)
Age: 32 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- I'm always worried about getting into a situation where I need a doctor but can't afford it.
- It's good to know there's support for something as serious as rabies.
- Working with animals, knowing treatment is affordable gives peace of mind.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 6 |
vet assistant (urban Texas)
Age: 45 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- I see how expensive treatment can get, so it's a relief that I wouldn't have to worry about rabies treatment costs.
- Policies like these help keep healthcare more accessible for those on temporary jobs.
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 | 6 | 5 |
self-employed artist (rural Alabama)
Age: 28 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 7/20
Statement of Opinion:
- Living remotely, knowledge about this policy provides a big relief. Veterinarian bills are unpredictable and high.
- This policy could save people like me huge burdens in emergencies.
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 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
restaurant manager (Los Angeles, CA)
Age: 52 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 16/20
Statement of Opinion:
- I've been in cities most of my life where rabies isn't commonly discussed, but it's reassuring to have coverage for the unexpected.
- While it's great, I hope the funds are distributed efficiently and fairly.
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 |
delivery driver (New York City, NY)
Age: 24 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- It's one less thing to worry about, especially when I'm out late and handling goods near pets.
- Having worked in different areas of NYC, knowing such a critical treatment is covered eases my mind.
- I think more needs to be done for general uninsured coverage but this is at least a start.
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 |
retired (Miami, FL)
Age: 60 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 8/20
Statement of Opinion:
- With all these stray animals around, especially feral cats, awareness of rabies is really needed.
- Any health assistance is welcomed when living on a budget. This is a good initiative.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
public school teacher (Chicago, IL)
Age: 38 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- Access to healthcare is crucial, this is one less worry in dealing with animal concerns.
- It's hearing stories from students about their pets and occasional stray encounters that make policies like this relevant.
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 | 7 | 6 |
| Year 20 | 7 | 6 |
freelancer (rural Pennsylvania)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Every time I'm out near wild areas, there’s a bit of dread about not having insurance for emergencies.
- This policy helps but comprehensive health coverage would be ideal.
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 |
student (suburban Colorado)
Age: 18 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- Good to know I won't be in financial trouble in case I need rabies shots from hiking or being around animals.
- While I'm healthy now, things like this policy add that layer of security.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
stay-at-home parent (urban Oregon)
Age: 40 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- Unexpected medical bills are a terror; knowing rabies won't pile on the stress is great.
- It's initiatives like these that help our family to feel safer.
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 | 5 |
| Year 20 | 8 | 5 |
Cost Estimates
Year 1: $25000000 (Low: $15000000, High: $40000000)
Year 2: $25750000 (Low: $15450000, High: $41200000)
Year 3: $26522500 (Low: $15913500, High: $42436000)
Year 5: $28075000 (Low: $16813500, High: $44800000)
Year 10: $31258750 (Low: $18724850, High: $49856000)
Year 100: $53139000 (Low: $31883400, High: $84896000)
Key Considerations
- The bill targets uninsured populations who might otherwise forgo necessary rabies treatment due to cost.
- Rabies has a low incidence rate in the U.S., but the costs of treatment are high, which necessitates specific targeted assistance to the uninsured.
- Balancing administrative costs with effective outreach to ensure accessibility is crucial.
- Potential public health benefits from reducing rabies cases could translate to long-term systemic healthcare savings.