President-Elect Donald Trump has chosen Congressman Tom Price, M.D. to be Secretary of Health and Human Services in his administration. First elected in November 2004, Congressman Tom Price, M.D. represents Georgia’s 6th District. For twenty years, he cared for patients as an orthopaedic surgeon in the Atlanta area.
Dr Tom Price has introduced the ‘Empowering Patients First Act’ in each of the last four Congresses (111th to 114th). Now known as H.R. 2300, the Bill was introduced for the first time in July 2009 and most recently in May 2015. On his website, Dr Price provides the text and an overview of the Bill. What does this Bill contain and how does it compare to President-Elect Donald Trump’s pre-election proposals?
In 2003, Dr Price gave an overview of his Bill.
Empowering Patients First Act – Main Points
- Full repeal of the Affordable Care Act (Obamacare)
- Tax credit to buy health insurance
- Provides a tax credit to buy health insurance in the individual market.
- Tax credit rises with age: $1,200 for 18 to 35, $2,100 for 35 to 50, $3,000 for over 50 and $900 per child up to age 18.
- Only for citizens or lawful permanent residents.
- Allows individuals to opt-out of Medicare, Medicaid, TRICARE, VA, FEHBP or employer subsidised group plan to receive tax credit for individual insurance instead.
- Expand Health Savings Accounts (HSAs)
- Limited deductions for employer provided health insurance
- Employers may deduct employee health insurance expenses from their taxable income up to a limit of: $20,000 for family coverage, $8,000 for individual coverage.
- Limitations on abortion funding
- From the overview of the legislation, “no federal funds authorized under, or credits or deductions allowed under … this bill may be used to pay for abortion (exceptions if the pregnancy endangers a women’s life or was the result of rape or incest) or cover any part of the costs of any health plan that includes coverage of abortion”.
- In addition, it “prohibits discrimination against any individual or health care entity that does not provide, cover, or pay for abortions, and allows for accommodations of the conscientious objection of a purchaser or health care provider when a procedure is contrary to the religious beliefs or moral convictions of such purchaser or provider.”
- Grants to States for high risk patients
- States receive grants for coverage through a high-risk pool, a reinsurance pool, or other risk adjustment mechanism, used for subsidising the purchase of personal health insurance.
- These government run plans are for people with existing medical conditions who cannot find affordable private health insurance.
- In the Bill introduced in May 2015, the section providing grants to States would sunset on 1 October 2018.
- Establish Association Health Plans (AHPs)
- Through their membership of a trade or professional association, small businesses can form Association Health Plans (AHPs) across state lines to purchase health insurance for their families and employees.
- Interstate market for health insurance
- Allows insurers licensed in one state to offer health insurance to residents of another state.
- Allows customers to purchase health insurance from another state.
- Medical lawsuit reform
- The Secretary of Health and Human Services shall issue clinical guidelines endorsed by medical specialty societies. Only guidelines approved and submitted by medical specialty societies shall be included in the guidelines.
- Adherence to clinical guidelines endorsed by medical specialty societies can be used as a defence in a medical lawsuit.
Major Similarities and Differences
- fully repeal the Affordable Care Act (Obamacare),
- allow health insurance policies to be sold across state lines.
- extend access to Health Savings Accounts, with tax-deductible contributions, and rollover to family members upon death.
The proposals differ on one major issue. For health insurance premiums, the Empowering Patients First Act offers tax credits whereas the Trump proposal provides tax deductions. Tax credits work like a voucher, allowing many more people the ability to afford private health insurance. This may have a greater impact on the Federal government budget, but save on funding public hospital facilities.
The Empowering Patients First Act makes more detailed proposals not necessarily in conflict with The Trump proposal. The Empowering Patients First Act:
- provides an initial $1,000 tax credit into a new HSA,
- protects an HSA from seizure in bankruptcy proceedings,
- limits deductions employers can make for health insurance premiums,
- limits Federal government funds that can be used for abortions,
- provides States with money for higher risk patients for a limited time, and
- changes the burden of proof in medical lawsuits.
 Office of the President Elect, President-Elect Donald J. Trump Intends to Nominate Congressman Tom Price as Secretary of Health and Human Services and Seema Verma as Administrator of the Centers for Medicare and Medicaid Services, 29 November 2016, https://www.greatagain.gov/news/president-elect-donald-j-trump-intends-nominate-congressman-tom-price-secretary-health-and.html