Bill Overview
Title: IMPROVE Act
Description: This bill specifies that individuals who elect to receive services in religious nonmedical health care institutions (RNHCIs) may receive COVID-19 vaccines under Medicare. Specifically, an individual's receipt of a COVID-19 vaccine does not revoke the individual's election to receive services in RNHCIs under Medicare; an individual who's election was revoked due to the receipt of a COVID-19 vaccine prior to the bill's date of enactment may immediately reelect to receive services in RNHCIs under Medicare.
Sponsors: Sen. Portman, Rob [R-OH]
Target Audience
Population: Individuals using RNHCIs under Medicare
Estimated Size: 10000
- The bill targets individuals who receive services at Religious Nonmedical Health Care Institutions (RNHCIs).
- It specifically addresses those who are eligible for Medicare, often older adults or those with certain disabilities.
- Prior to this bill, choosing to receive a COVID-19 vaccine could revoke the election to receive services in RNHCIs. This bill changes that provision.
- The global impact mainly includes populations in countries with Medicare-like systems or specific arrangements with the U.S.
Reasoning
- Given the budget constraints, the policy aims to target a relatively small group of people within the broader Medicare population. The target population specifically consists of those who use Religious Nonmedical Health Care Institutions (RNHCIs).
- These institutions are not widely used across all Medicare beneficiaries, suggesting a more focused demographic, potentially those with strong religious or personal convictions against traditional medical care methods.
- The budget limits mean prioritization within this group, likely focusing on the most impacted individuals.
- The policy will likely have a varied impact based on personal values related to both healthcare access and religious practices. Some might highly value continued access to RNHCIs, while others may not value it if alternative care options were already pursued.
Simulated Interviews
Retired Teacher (Tennessee)
Age: 72 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- This policy is comforting because I no longer have to choose between my religious beliefs and vaccination.
- Previously, receiving a vaccine meant losing access to my preferred care, which was stressful.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 5 |
| Year 10 | 9 | 4 |
| Year 20 | 8 | 4 |
Farmer (Texas)
Age: 66 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 3/20
Statement of Opinion:
- It's beneficial, it allows me to reconsider vaccination without worrying about losing care.
- It's a relief that past decisions don't affect my current care preferences.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 3 |
| Year 20 | 7 | 3 |
Retired Nurse (California)
Age: 82 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 1.0 years
Commonness: 4/20
Statement of Opinion:
- I'm still unsure about the vaccine, but knowing it won't affect my care removes a lot of pressure.
- The policy is good for others, but I have no immediate plans to vaccinate.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Retired Pastor (Florida)
Age: 70 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 6/20
Statement of Opinion:
- I'm relieved that I can now get vaccinated with peace of mind
- This policy helps align my health practices with community beliefs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 3 |
Homeopathy Practitioner (New York)
Age: 69 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 2/20
Statement of Opinion:
- This policy doesn't change much for me personally as I've already been vaccinated while using RNHCIs.
- Good foresight for others in the RNHCI community who were hesitant.
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 | 5 |
| Year 20 | 6 | 5 |
Office Manager (Illinois)
Age: 58 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 0.0 years
Commonness: 3/20
Statement of Opinion:
- The policy is reassuring, but I still have no plans to get vaccinated.
- I value having the option without a penalty.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
Retired Engineer (Ohio)
Age: 74 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- This policy allows me to reconnect with my former healthcare network post-vaccination.
- It's a long-awaited change for people like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 4 |
Retired Librarian (Washington)
Age: 67 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 0.0 years
Commonness: 4/20
Statement of Opinion:
- It maintains personal choice, but I don't foresee using RNHCIs more often.
- Positive for community members with different needs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Yoga Instructor (Colorado)
Age: 60 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 2/20
Statement of Opinion:
- It represents a considerate step towards inclusion of different medical traditions.
- Happy the policy exists even if it doesn't change much for me now.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Retired Artist (Oregon)
Age: 85 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 1/20
Statement of Opinion:
- This policy facilitates my return to preferred care practices.
- Grateful for the chance to align health decisions with beliefs without penalty.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
Cost Estimates
Year 1: $5000000 (Low: $4000000, High: $7000000)
Year 2: $5000000 (Low: $4000000, High: $7000000)
Year 3: $5000000 (Low: $4000000, High: $7000000)
Year 5: $5000000 (Low: $4000000, High: $7000000)
Year 10: $5000000 (Low: $4000000, High: $7000000)
Year 100: $5000000 (Low: $4000000, High: $7000000)
Key Considerations
- The RNHCIs represent a small sector of Medicare but address critical community care needs.
- The bill seeks to promote health equity by not penalizing individuals for receiving a vaccine.
- There is a negligible financial risk due to the small targeted population.