This bill would require the Dept. of Health and Human Services (HHS) to offer a public health insurance option that would be available nationwide to consumers through health insurance exchanges. The public health insurance plan would seek to provide another choice for consumers, in addition to offering competitive, stable, and high-quality healthcare coverage. HHS’ responsibility under the bill would be to create a low-cost plan that doesn’t compromise on quality or access to care.
This legislation would also require the public health insurance option to conform to certain characteristics, including that it:
Would only be available through health insurance exchanges;
Must comply with requirements that apply to other health insurance plans, such as those related to benefits, benefit levels, provider networks, notices, consumer protections, and cost sharing;
Must offer bronze, silver, and gold plans.
HHS would have to collect data needed to set premiums and payment rates for the public health insurance option and adjust premiums for regional differences to cover administrative costs. It also would have the ability to use innovative methods to determine how payments for items and services are paid out by the public health insurance option.
In its first three years of operation, HHS would also be required to set payment rates for the public option while also providing for greater payments during that time period.
All startup costs for the public health insurance option would be required to be repaid over a 10-year period.