Summary#
The Measuring State Healthcare Freedom Act would require the Department of Health and Human Services’ Assistant Secretary for Planning and Evaluation to study health care competition and consolidation in each of the 10 years after enactment. Its stated goal is to measure these issues across states; the bill does not change health care rules or guarantee any particular result. It has been introduced and referred to the House Energy and Commerce Committee, so it is not law.
- The Assistant Secretary must consult the Federal Trade Commission (FTC) Chair and the Justice Department’s Assistant Attorney General for Antitrust.
- The study must collect data on health care licensing requirements; mergers and acquisitions; state laws on hospital mergers and construction of new health facilities; and alternative insurance coverage.
- It must track the number of specified kinds of health care organizations at the start and end of each year, and calculate concentration measures for specified services.
- The Assistant Secretary must send an annual report to four congressional committees and publish it, along with the collected data, in a publicly accessible, interactive format.
- The Assistant Secretary may request needed information from the FTC. If requested, the FTC Chair must provide it.
What it means for you#
- Public: You would be able to access the annual reports and datasets online if the bill becomes law and the office publishes them as required.
- Health care providers, insurers, and state governments: The bill includes information about their sectors or state laws in the study, but does not require them to change their rules or practices or to submit information.
- Patients and health care workers: The bill does not directly change licensing requirements, insurance coverage, access to care, or the number of providers.
- Taxpayers: The bill creates a federal study and reporting duty, but does not state how it would be funded.
Money#
No cost information is in the available material.
- The bill requires the Assistant Secretary’s office to conduct 10 years of studies and publish reports and data, but gives no cost estimate or staffing details.
- It does not specify an appropriation, fee, tax, fine, or payment to states or health care organizations.
What is unclear#
- The bill does not set out the study’s methods or explain how the office should ensure data are complete and comparable across states.
- It does not define several terms, including “medical practices” and “health insurance providers.”
- It leaves the Assistant Secretary to define geographic areas for the concentration measures, in consultation with the FTC’s Bureau of Competition.
- It does not require states or health care organizations to provide data, or set out a process for collecting information from them.
- It does not state what happens if data are unavailable or how the 10-year study and reporting work would be paid for.
Case for#
- A possible argument for the bill is that a consistent, public record could help Congress and the public compare competition and consolidation across states.
- The required topics cover several parts of the health care system, including licensing, mergers, facility growth rules, insurance options, and provider numbers.
- Annual reports and interactive public data could make changes over time easier to examine.
- Consultation with federal competition and antitrust officials could bring relevant expertise to the study.
Case against#
- The bill does not require states or health care organizations to provide information, which could leave gaps in the data.
- It leaves important methods and definitions to the Assistant Secretary, which could make comparisons less clear or consistent.
- The bill requires 10 years of work but provides no cost estimate, staffing plan, or stated funding source.
- The bill collects and publishes information but does not require any action if the study finds high concentration or barriers to competition.