Legislation Comparison Grid and Testimony/Advocacy Statement

Part 1: Legislation Comparison Grid

Legislative Intent of the Bill

Senators Patty Murray and Lamar Alexander introduced the Lower Health Care Costs Act in 2019 (Gudiksen, 2019). The intent of this legislative bill was to address various inefficiencies that exist in the healthcare markets. Other reasons that led to the release of this bill were to enhance competition as well as decrease the costs associated with the provision of healthcare services. Further, the intentions of the bill are demonstrated in the five titles that make up this Act. For example, the legislation aimed at ending surprise medical bills that occurred when a patient obtained care from an out-of-network provider (AHIP, 2019). The bill advocated for a cost-sharing approach. Therefore, a patient would only pay an amount that is equivalent to the charges applicable if the care was provided by an in-network provider. Secondly, it focused on reducing the charges of the prescribed drugs. The Act required the manufacturers of drugs to submit a report to the relevant authorities in case of price increases in certain drugs.

Another intent, as stated in the third title, is to increase transparency in healthcare. For instance, the bill advocated for the removal of the gag clauses on price as well as quality information that prevented the enrollees from viewing the costs and accurate and complete data on providers (Gudiksen, 2019). Moreover, the Lower Health Care Costs Act is intended to enhance public health by increasing awareness of disease prevention and training the health care providers, among others. As per the fifth title, the bill was meant to refine the exchange of health information (AHIP, 2019). For instance, it required healthcare entities to recognize cybersecurity practices when conducting audits.

Proponents and opponents of the Lower Health Care Costs Act

Some of the proponents of this Act include the Senate HELP leaders Lamar Alexander and Patty Murray, who introduced the bill (American Hospital Association, 2019). They argued that the legislation would ensure the patients remain harmless from surprise medical bills. Besides, the bill would allow drugs to enter the market earlier than under current law. Moreover, this legislation would ensure increased access to health as well as cost and quality information.

The opponents to the Lower Health Care Cost Act include the American College of Surgeons (ACS). They argued that an independent dispute resolution (IDR) process was bypassed by the Act (American College Surgeons, 2019). Further, they indicated that solving the issue of surprise billing should allow the insurers and the physicians to negotiate a final payment by holding an IDR in order to protect the patients from anticipated medical bills. Another opponent to the Lower Health Care Costs Act is the Public Citizen Research Group, which required the exclusion of Section 207-biological Product Innovation (PublicCitizen, 2019). They argued that this section was a threat to the safety of the patient since it excluded biological medicines from the requirements of adhering to quality standards.

Target Population

The population targeted by this bill is the patients who are subjected to surprise billings. The legislation was developed to protect such patients by adopting the cost-sharing approach, which is fair to all parties. Besides, the bill ensured drugs were available to the patients since it supported the idea of reducing the prices for prescription drugs.

Status of the bill (is it in hearings or committees? Is it receiving press coverage?

The bill was introduced to the Senate, where it was read twice before being referred to the Health, education, labor, and Pensions Committee. The current status of the bill is that it was placed on the Senate legislative calendar under general orders.

The public attention obtained from various individuals is an indication that the bill is receiving press coverage. Consumer reports from Washington urge Congress to approve this Act to aid in stopping the surprise medical bills (Mendelsohn & Butler, 2019). For instance, senior policy counsel requires voting for the bill to aid in stopping the medical bills that threaten the patients.

Part2: Legislative testimony/Advocacy Statement

The legislation should be enacted due to many reasons. For example, everyone has the right to accessible medical care. Thus, patients should not be subjected to surprise medical bills since it results in emotional and financial stress. Secondly, the bill should be passed in order to aid in reducing the prices of the prescribed drugs. Moreover, authorizing the bill would help in increasing the levels of transparency in various hospitals. Other benefits that would be derived from enacting this legislation include enhancing the exchange of information and investment in public health. Failing to authorize the bill means that the patients will continue to be subjected to surprise medical bills, which may discourage them from seeking medical care in the future.

To ensure the legislation is acceptable to numerous individuals, it is advisable to include the viable views of the opponents. Although ACS concurs with the efforts of protecting the patients from unanticipated medical bills, it argued that the IDR was not considered in the legislation. Thus, I would ensure the IDR process is regarded as we endeavor to protect the patients. Failing to apply this process provides unfair powers to the parties involved. Therefore, I would advocate for the use of IDR since it has proven effective in solving similar issues in various states. In the case of the Public Citizen Research Group, I would review if a threat exists, as argued in section 207. In case of the existence of a risk, I would consider reviewing this section. For instance, I would ensure that biological medicines are included in the legislation.

Thus, they should adhere to the set standards that are required for the other categories of medicine. Otherwise, I would advise the opponents why biological medicine should be excluded as per the section. For example, I would inform them of the demerits that may result from including such medicines in the legislation.

References

AHIP. (2019). Summary of S. 1895, Lower Health Care Costs Act. Retrieved from https://www.ahip.org/wp-content/uploads/ahip_summary_07_02_19_v1.pdf

Gudiksen, K. (2019). The Lower Health Care Costs Act: A bipartisan federal effort to improve competition in healthcare markets. Retrieved from https://sourceonhealthcare.org/the- lower-health-care-costs-act-a-bipartisan-federal-effort-to-improve-competition-in-healthcare- markets/

American College Surgeons. (2019). American College of Surgeons opposes the lower health care costs Act. Retrieved from https://www.prnewswire.com/news-releases/american- college-of-surgeons-opposes-the-lower-health-care-costs-act-300872386.html

PublicCitizen. (2019). Letter to Congress opposing section 201 of S.1895, the Lower Health Care Costs Act. Retrieved from https://www.citizen.org/article/letter-to-congress-opposing- section-207-of-s-1895-the-lower-health-care-act/

American Hospital Association. (2019). Senate HELP leaders introduce lower health care costs Act. Retrieved from https://www.aha.org/news/headline/2019-06-19-senate-help-leaders- introduce-lower-health-care-costs-act

Mendelsohn, D. & Butler, D. (2019). Consumer reports urge Congress to approve the Lower Health Care Costs Act to end surprise medical bills before the year’s end. Retrieved from https://advocacy.consumerreports.org/press_release/consumer-reports-urges-congress-to- approve-lower-health-care-costs-act-to-end-surprise-medical-bills-before-years-end/

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To Prepare:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)Be sure to add a title page, an introduction, a purpose statement, and a conclusion. This is an APA paper. Part 1: Legislation GridBased on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.

Identify the proponents/opponents of the bill.

Identify the target populations addressed by the bill.

Where in the process is the bill currently? Is it in hearings or committees?

Part 2: Legislation Testimony/Advocacy StatementBased on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.

Explain how the social determinants of income, age, education, or gender affect this legislation.

Describe how you would address the opponent to your position. Be specific and provide examples.

At least two outside resources and 2-3 course-specific resources are used.