Sen. Mike Braun, Sen. Tammy Baldwin (D-WI), and Rep. Michelle Steel (R-CA) introduced a bipartisan, bicameral bill to promote transparency in health care, crack down on anti-competitive practices, and remove restrictions preventing competition in health care markets.
The “Healthy Competition for Better Care Act” enables more group health plans and health insurance issuers to enter into agreements with providers that guide enrollees to high-value providers and provide incentives to encourage enrollees to seek higher-quality, lower cost care.
“Competition is the key to creating a health care market with options and transparency, which drives down costs. The entire health care industry should be encouraging healthy market competition to lower costs and improve the quality of care received by Americans in every state,” said Senator Braun.
“No American should go broke to afford the health care they need. For too long, we have seen a lack of competition in our health insurance marketplace drive up costs for patients and limit their affordable options,” said Senator Baldwin. “Our legislation will crack down on big health system’s anti-competitive practices to increase transparency, cut costs, and connect more Wisconsinites with the quality care they need.”
The legislation was previously passed by the Senate Health, Education, Labor, and Pensions Committee in 2019. According to the Congressional Budget Office (CBO), policies that would ban these contracting terms would reduce premiums in the private insurance market and increase federal revenues by $1.1 Billion.
The “Healthy Competition for Better Care Act” will:
- Allow discounts or incentives for enrollees who choose high-quality and low-cost providers.
- Allow insurers and employers to contract with the right hospitals and providers for their patients, without requirements to enter into additional contracts with other affiliated providers or hospitals.
- Allow health insurance issuers to negotiate their own rates with other providers who are not party to the contract of the provider involved.
- Allow hospitals and issuers to freely negotiate prices, without requirements to pay higher amounts for items or services than other issuers have agreed to. The bill includes exceptions for certain group model issuers, including health maintenance organizations, and value-based network arrangement, such as an exclusive provider network or accountable care organization.