Bill Overview
Title: Equity in STD Testing Act
Description: This bill provides for coverage, without cost-sharing, of testing for certain sexually transmitted diseases under Medicare Advantage, Medicaid, the Children's Health Insurance Program (CHIP), TRICARE, Department of Veterans Affairs health benefits, and the Indian Health Service.
Sponsors: Rep. Williams, Nikema [D-GA-5]
Target Audience
Population: People enrolled in public health programs eligible for STD testing coverage
Estimated Size: 150000000
- The bill specifically mentions coverage for testing of sexually transmitted diseases (STDs) under several public health programs.
- Key target populations include beneficiaries of Medicare Advantage, Medicaid, CHIP, TRICARE, VA health benefits, and the Indian Health Service.
- Medicare Advantage primarily covers elderly individuals over 65, though some people with disabilities below that age are also covered.
- Medicaid serves low-income individuals and families, including many children, pregnant women, elderly individuals, people with disabilities, and, in some states, low-income adults without children.
- CHIP is targeted at children in families with incomes too high to qualify for Medicaid but too low to afford private coverage.
- TRICARE serves service members, veterans, and their dependents.
- VA health benefits are for military veterans.
- The Indian Health Service provides medical and public health services to American Indians and Alaska Natives.
Reasoning
- Ensuring coverage for STD testing under major public programs affects a large segment of the population, primarily those who are low-income, senior citizens, children in low-income families, active military members and veterans, and American Indians and Alaska Natives.
- The budget constraints suggest the policy is intended for broad coverage initially, but may require prioritization of high-risk groups or specific regions depending on STD prevalence and healthcare access issues.
- The well-being impact is likely to vary from high for those who face financial barriers to testing, to low or none for those who already have STD testing coverage through other means or who are not sexually active.
- In considering the interviews, a mix of people from different regions, occupations, and backgrounds should be included to reflect the policy's diverse impact.
Simulated Interviews
retired (California)
Age: 72 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- I appreciate any policy that helps make healthcare more affordable.
- With a fixed income, every little bit of saving counts.
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 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 5 |
unemployed (Texas)
Age: 35 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- This policy will help me stay healthy without worrying about STD testing costs.
- Health concerns shouldn't be a barrier to finding work.
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 | 9 | 5 |
| Year 20 | 9 | 4 |
nurse (New York)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- Ensuring STD testing is covered for military families is essential for health.
- This policy supports my work, where prevention is key.
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 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
veteran (Florida)
Age: 60 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- As a veteran, I know many will benefit from easier access to STD tests.
- Good health access is vital for our community.
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 | 7 | 6 |
| Year 20 | 7 | 6 |
student (South Dakota)
Age: 19 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- This policy means my family can save money while ensuring I'm healthy before starting college.
- It's a relief to have these supports.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 8 |
| Year 2 | 9 | 7 |
| Year 3 | 9 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
construction worker (Arizona)
Age: 53 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- STD testing is crucial for our underserved community.
- This policy should help reduce diseases on the reservation.
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 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
single mother (Illinois)
Age: 29 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- Healthcare expenses can be stressful for single parents.
- This coverage means one less thing to worry about.
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 | 8 | 4 |
| Year 20 | 8 | 3 |
NGO worker (Washington)
Age: 27 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 9/20
Statement of Opinion:
- I'm glad to see more public health support for preventive testing.
- Such policies help my community-focused work immensely.
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 | 8 | 6 |
retired teacher (Mississippi)
Age: 66 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- I'm all for any policy that aids retirees in maintaining health.
- Costly medical bills greatly affect fixed-income individuals.
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 | 6 |
waitress (Oregon)
Age: 22 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 8/20
Statement of Opinion:
- Balancing school expenses is tough; this will help with medical costs.
- Glad to see health equity being addressed.
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 | 6 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Cost Estimates
Year 1: $300000000 (Low: $250000000, High: $360000000)
Year 2: $310000000 (Low: $260000000, High: $370000000)
Year 3: $320000000 (Low: $270000000, High: $380000000)
Year 5: $340000000 (Low: $290000000, High: $400000000)
Year 10: $360000000 (Low: $310000000, High: $420000000)
Year 100: $380000000 (Low: $330000000, High: $440000000)
Key Considerations
- Achieving cost balance between immediate higher testing expenses and potential long-term healthcare savings.
- Influence of this policy on healthcare access disparities, especially among marginalized and low-income groups.
- Potential resistance from stakeholders who favor cost-sharing mechanisms as a means to manage healthcare utilization.