Rep. Pete Sessions Introduces Sweeping Health Care Reform Bill in Congress

U.S. Rep. Pete Sessions (R-TX) introduced a comprehensive reform bill titled the Health Care Fairness for All Act, on May 9.

The bill provides a universal tax credit and individual accounts for after-tax savings for medical expenses that would be invested and never taxed again (called Roth taxation), states Sessions’ press release on the bill.

“This legislation would create a new option for Americans to obtain health care coverage via a health insurance tax credit that is portable, fair, and available to all Americans,” Sessions’ press release states. “The bill would also reduce health care costs, promote price transparency and competition, and would allow all Americans to save and pay for health care with a tax-advantaged Roth Health Savings Account (HSA).”

Americans for Prosperity (AFP), a free-market advocacy group, supports Sessions’ bill because it offers individuals and families a choice of options, says AFP Senior Health Policy Fellow Dean Clancy, in Sessions’ press release.

“We are proud to endorse this bill because it offers American families a personal option in health care—sensible reforms that ensure lower prices, less hassle, and more personal choice and control without new taxes,” said Clancy. “The Health Care Fairness for All Act will make health care dramatically fairer by giving every American access to a generous new subsidy that lets you tailor your health care benefits to fit your individual needs—and then take them with you when you change jobs.”

AFP defines “personal option” as “a commonsense alternative to plans like the public option that put government in key control.”  AFP used the term in recent polling but alternatives to a public option could entail affordable health insurance, reasonably priced drugs, and price transparency.

Saving for Medical Care

Individuals and families would use the tax credit—which is refundable and advanceable for low-income people—to purchase health insurance, said John Goodman, president of the Goodman Institute of Public Policy Research and co-publisher of Health Care News, in Sessions’ press release.

“For millions of Americans, health insurance is unaffordable and inaccessible,” said Goodman. “The Health Care Fairness for All Act will give each American citizen access to a refundable, advanceable, and assignable health tax credit to be used to purchase health insurance, buy medical care, and make deposits to a Health Savings Account,” said Goodman. “This bill will free the health care marketplace to meet the different needs of different families, and provide health care financial support to every individual, including the uninsured.”

Sessions and Goodman discussed how health insurance, including Obamacare (ACA) plans, is not affordable for many people, in a Goodman Institute podcast recorded on May 3.

“The average deductible for a family is $8,500,” said Goodman. “Only hospitalization can reach this in high-deductible policies.”

Democrats are pushing Medicare-for-All, said Sessions.

“But Medicare is not designed for children or young people,” Sessions said.

The ACA’s subsidy structure discourages lower-income people from working, said Goodman.

“We need people to go out and work without losing benefits,” said Goodman.

The current system discriminates against the self-employed and increases government dependency on lower-income people, said Goodman.

“Taking an entirely different approach, the Sessions bill aims to create health care parity” for the self-employed by providing $12,000 in tax credits for a family of four, said Goodman.

Replaces Expiring Tax Credits

The Sessions legislation is a welcome change of course in health care policy, says Robert A. Koshnick, M.D., chair of the policy committee of the Minnesota Medical Association,  who has proposed what he calls Empower-Patient Accounts (see related article, page 19).

“This bill could be a legislatively disruptive innovation that could re-create a patient-friendly, cost-effective medical care market that will reduce health care costs, improve quality, and raise patient and physician satisfaction,” said Koshnick.

Congress will be forced to address health care because of time limits in current tax law, says Koshnick.

“Health care will be front and center in the 2024 election because tax credits for health insurance premiums are set to expire in 2025,” said Koshnick. “It is vital that any bill be ‘forward-looking.’ Elections are decided by what people expect a political party will give them in the future.”

Koshnick says his empower-patient accounts could be an entryway to the Roth HSAs proposed in the Sessions bill.

“The nation’s mindset would begin to see that costs go down by paying directly for health care instead of through a third party—private (insurers) or the government,” said Koshnick.

‘Removes Needless Barriers’

The Sessions bill would make health care affordable in three key ways, Clancy said, in an AFP statement.

“First, it funds patients rather than insurance companies, said Clancy. “Second, it empowers every American to shop for value with a tax-advantaged health savings account. And third, it removes needless barriers between patients and innovative, life-saving care delivered by the medical professionals they trust.”

The bill can appeal to Democrats and Independents, Clancy told Health Care News.

“With Obamacare, people were promised if they liked their health care, they could keep it,” said Clancy. “This bill actually does that and more. It preserves existing safety-net programs and protects people with pre-existing conditions. If you want lower prices, more freedom, and fairness for all—this bill is for you, too.”

Bonner Russell Cohen, Ph.D. (bcohen@nationalcenter.org) is a senior fellow at the National Center for Public Policy Research.

Internet Info:

“The Health Care Fairness for All Act,” H.R. 3129, May 9, 2023: https://www.congress.gov/bill/118th-congress/house-bill/3129?s=1&r=2