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: Sen. Booker, Cory A. [D-NJ]
Target Audience
Population: Global beneficiaries of Medicare and Medicaid
Estimated Size: 110000000
- The bill targets social determinants of health and health disparities, focusing on minorities, underserved areas, and high-risk individuals.
- The bill pertains to Medicare and Medicaid, which are US-specific healthcare programs. Therefore, it primarily impacts beneficiaries in the United States who are covered under these programs.
- Medicare is primarily used by individuals who are 65 years or older, disabled, or have End-Stage Renal Disease.
- Medicaid serves low-income individuals including children, adults, elderly, and people with disabilities.
- Given the focus on minorities and underserved areas, this population will include a significant proportion of racial and ethnic minorities in the US who are either currently on or eligible for Medicare and Medicaid.
Reasoning
- The policy is focused on addressing social determinants of health and disparities within the Medicare and Medicaid populations, particularly for minorities, underserved areas, and high-risk individuals.
- Given the substantial funding and broad inclusiveness of the policy, it will particularly affect those groups negatively impacted by systemic inequalities in healthcare.
- Demographics targeted by Medicare and Medicaid predominantly include older adults, low-income families, and racial and ethnic minorities. These groups often experience lower self-reported wellbeing due to systemic healthcare gaps.
- Considering the scope and budget, this policy can significantly improve wellbeing scores if effectively implemented, but the impact will vary based on individual circumstances, local healthcare infrastructures, and the extent of systemic barriers.
Simulated Interviews
Retired Teacher (New Orleans, LA)
Age: 78 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- I hope this policy helps people like me who couldn't always get the care we needed.
- Healthcare disparities have been an issue all my life, and this change is overdue.
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 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 9 | 5 |
Construction Worker (Phoenix, AZ)
Age: 45 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- It's tough maintaining my health with my job. Anything that gives an extra bit of support would be great.
- I'm skeptical until I see real changes in my costs or care.
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 | 6 | 4 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Retired Factory Worker (Detroit, MI)
Age: 66 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- I've seen friends struggle with medical costs, and this sounds like it'll help us a lot.
- Hope this adjusts for all grandparents out here trying to stay afloat.
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 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Unemployed (Rural West Virginia)
Age: 52 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- This policy sounds promising but I doubt it'll reach rural areas like mine.
- I really want to see improvements in access to specialists.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Software Engineer (San Francisco, CA)
Age: 30 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- I'm happy to see policies helping those less privileged.
- This won't affect me directly, but it's good for society.
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 |
Taxi Driver (Chicago, IL)
Age: 55 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- I think this policy is a step in the right direction for people like me dealing with ongoing medical issues.
- Proper medical guidance under Medicare and Medicaid has been limited.
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 | 8 | 6 |
| Year 20 | 8 | 6 |
Retired Nurse (Charleston, SC)
Age: 70 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- I've been through the throes of Medicare maze, and any simplification would be welcome.
- Hope it's more than just lip service, we need structural changes.
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 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Graduate Student (Austin, TX)
Age: 27 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- Preventive care is essential, and any boost to this would help many stay healthy.
- The policy seems like it'll address systemic issues, which has long been needed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 8 |
Retired Veteran (Miami, FL)
Age: 83 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 25.0 years
Commonness: 7/20
Statement of Opinion:
- Any improvements to healthcare are important for veterans like me.
- Hope these efforts will reach all older veterans with special needs.
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 | 8 | 6 |
| Year 20 | 8 | 6 |
Gig Worker (Brooklyn, NY)
Age: 33 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 12.0 years
Commonness: 6/20
Statement of Opinion:
- I'm cautiously optimistic, but usually folks like me get overlooked.
- If this policy focuses on actual local healthcare improvements, it'll help a lot.
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 | 5 |
| Year 20 | 8 | 5 |
Cost Estimates
Year 1: $3000000000 (Low: $2500000000, High: $3500000000)
Year 2: $3200000000 (Low: $2700000000, High: $3700000000)
Year 3: $3400000000 (Low: $2900000000, High: $3900000000)
Year 5: $3600000000 (Low: $3100000000, High: $4100000000)
Year 10: $4000000000 (Low: $3500000000, High: $4500000000)
Year 100: $5000000000 (Low: $4500000000, High: $5500000000)
Key Considerations
- The bill's success hinges on effective collaboration between federal, state, and community stakeholders.
- There is potential for significant cost savings if the models demonstrate improved health outcomes that reduce medical interventions.
- Initial costs might be high due to the need for infrastructure setup and workforce training.
- Monitoring and evaluation will be critical to ensure the models' effectiveness in addressing disparities.