Sen. Ted Cruz, R-Texas, has used the excitement surrounding the King vs. Burwell (Case 14-114) U.S. Supreme Court case as a chance to introduce his own health system change bill.
S. 647, the Health Care Choice Act bill, would repeal the Patient Protection and Affordable Care Act (PPACA).
The bill then would create a new “cooperative governing” system for individual health coverage. A health insurance issuer would designate one state as its “primary state,” and submit itself to regulation by the regulators in that state.
Regulators in other states, or “secondary states,” would then have to defer to the primary state in many situations.
Critics of “association health plan” proposals,” or proposals that let insurers sell health insurance across state lines, have argued that most health insurers will end up basing themselves in a state that makes little effort to keep tabs on insurers. PPACA itself allows the sale of a Multi-State Plan (MSP) option, a kind of plan regulated mainly by the U.S. Office of Personnel Management, but HHS ended up developing regulations that, in practice, seem to require MSPs to comply with many state regulations.
Cruz has tried to deal with that concern by including mechanisms to keep the primary state from shirking regulatory responsibilities.
For a more detailed look at some of the bill’s provisions, read on.
1. The bill uses a broad definition of the term “state.”
Some parts of PPACA include only the 50 states and the District of Columbia in the definition of “state.”
S. 647 would use “state” to apply to the 50 states, the District of Columbia, and Puerto Rico, the Virgin Islands, Guam, American Samoa and the Northern Mariana Islands.