Dr. Marshall Introduces Legislation to Drive the Cost of Health Care Down and Increase Patient Choice

April 11, 2019
Press Release

WASHINGTON, D.C.-This week, Congressman Dr. Roger Marshall introduced H.R. 2183- The State Flexibility and Patient Choice Act of 2019. This legislation would drive the cost for health care down and increase patient choice by empowering states to come up with innovative solutions to stabilize their individual and small group markets.

“I have long said, in order to fix our broken health care system, we must focus on solutions that prioritize transparency, innovation, and consumerism,” Rep. Marshall said. “This bill is designed to give more power to states so that they have the freedom to develop programs and policies that will focus on cost and patient choice. I am proud of this legislation, it’s a great step in the right direction.”

The State Flexibility and Patient Choice Act would streamline Section 1332 of the Affordable Care Act (ACA), the State Innovation Waivers application process by allowing states to waive certain requirements of the ACA to implement their own plan to provide health insurance to residents.
To obtain a waiver under the proposed guidelines of the legislation, a state must have a waiver signed into law and demonstrate that the plan will not increase the federal deficit and will provide coverage to the same number of citizens.
“My goal is to help get more people covered and drive down the cost for patients in the process.” Rep. Marshall said. “I believe that each state has unique needs and demands and shouldn’t be forced to fit a one-size-fits-all model. It’s simple; this bill could help pave the way for Kansans to make health care decisions for Kansans by eliminating arbitrary processes mandated by Obamacare.”
Currently, eight states have approved a 1332 waiver, and seven of them are reinsurance programs. Congressman Marshall’s legislation would take the hassle out of the waiver application process that has proved to be convoluted and difficult for states to navigate. The State of Maryland has an approved waiver to introduce a reinsurance program to lower premiums and stabilize their markets. Their well-run reinsurance program has shown success in decreasing people’s premiums this year and was praised as a collaborative, bipartisan success story between Maryland and the Administration.
“It’s incredible what people can accomplish when we give them freedom and choices,” Rep. Marshall said. “This legislation will help streamline the process and encourage other states to follow success like Maryland to apply for a waiver so they have the flexibility and freedom to come up with solutions that help patients get the healthcare they need at an affordable price.”

Dr. Marshall’s legislation would: 

  • Continues to protect those with pre-existing conditions.
  • Creates an expedited process for identical or significantly similar applications of approved waivers.
  • Amends the contract year terms from 5 to 6 years to consider states with two-year budget cycles.
  • Helps Basic Health Programs (BHPs) to utilize all available pass-through funding.
  • Allows for consideration of other state-federally funded sources (i.e. CHIP and Medicaid).
  • Amends budget neutrality so a state’s savings are considered throughout the entire contract period, rather than annually.


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