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US S2519

US S2519
Empowering Patients First Act of 2015


summary

Introduced
02/09/2016
In Committee
02/09/2016
Crossed Over
Passed
Dead
01/03/2017

Introduced Session

114th Congress

Bill Summary

Empowering Patients First Act of 2015 This bill repeals the Patient Protection and Affordable Care Act and the health care provisions of the Health Care and Education and Reconciliation Act of 2010, effective as of their enactment. This bill replaces those provisions with amendments to the Internal Revenue Code, the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 (ERISA) to address health care coverage. The bill provides for refundable tax credits for health insurance coverage and health savings account (HSA) contributions. The bill raises the annual HSA contribution limit, expands eligibility for tax-deductible HSA contributions, and allows HSAs to be used to pay periodic or capitated primary care fees. A limit is placed on the amount of an employer's contribution to health coverage that can be excluded from the employee's taxable income. The Department of Health and Human Services (HHS) must provide a grant to each state for high-risk pools or reinsurance pools to subsidize health insurance for high-risk populations and individuals. Funds authorized, tax credits, and tax deductions under this Act may not be used to pay for an abortion or health coverage that includes abortion, with exceptions. This bill provides for the establishment and governance of independent health pools, entities that form risk pools to offer health insurance coverage to their members. Small Business Health Fairness Act of 2015 This bill provides for the establishment and governance of association health plans, which are group health plans sponsored by business associations that meet certain ERISA certification requirements. Health insurers offering individual coverage may deny coverage to an individual, outside of open enrollment periods. Preexisting conditions may be excluded from coverage under certain conditions. Individual health insurance coverage is governed by the laws of a state designated by the health insurance issuer. HHS must issue clinical practice guidelines. The bill specifies how these guidelines may be used in a health care lawsuit. HHS may not use comparative effectiveness research or patient-centered outcomes research to deny coverage of an item or service under a federal health care program. This bill amends title XVIII (Medicare) of the Social Security Act to permit Medicare beneficiaries to contract with a physician or practitioner for covered health care and submit a claim for payment under Medicare. Health care professionals are exempted from federal and state antitrust laws in connection with negotiations with a health plan to provide health care items or services.

AI Summary

This bill, the Empowering Patients First Act of 2015, proposes to repeal the Patient Protection and Affordable Care Act (PPACA) and related provisions of the Health Care and Education Reconciliation Act of 2010, replacing them with a new framework for health coverage. Key provisions include the introduction of refundable tax credits for health insurance and health savings account (HSA) contributions, with increased HSA contribution limits and expanded eligibility. It also limits the amount of employer contributions to health coverage that can be excluded from an employee's taxable income. The bill mandates federal grants to states for high-risk pools or reinsurance to help subsidize insurance for high-risk individuals. Furthermore, it establishes independent health pools and association health plans, which are group health plans sponsored by business associations, allowing insurers to deny coverage outside of open enrollment periods and potentially exclude preexisting conditions under certain circumstances. The bill also includes provisions related to medical malpractice reforms, such as changing the burden of proof in lawsuits if treatment aligns with clinical practice guidelines and allowing states to create administrative health care tribunals. It also permits Medicare beneficiaries to contract directly with physicians for services and submit claims, and exempts healthcare professionals from antitrust laws when negotiating with health plans. Finally, the bill aims to increase transparency by requiring states to provide information on health coverage options and providers.

Committee Categories

Budget and Finance

Sponsors (2)

Last Action

Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S740-741) (on 02/09/2016)

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