H.R.3864 - Protecting Health Care for All Patients Act of 2025 (119th Congress)
Summary
H.R.3864, the Protecting Health Care for All Patients Act of 2025, aims to amend Title XI of the Social Security Act. The bill seeks to prohibit the use of quality-adjusted life years (QALYs) and similar measures in coverage and payment determinations under federal health care programs. It also adjusts funding for the Prevention and Public Health Fund and mandates a report on the impact of QALYs on individuals with intellectual and developmental disabilities.
Expected Effects
The bill's passage would prevent federal healthcare programs from using QALYs, potentially altering how healthcare resources are allocated. This could lead to changes in coverage decisions and payment structures within Medicare, Medicaid, and other federal health programs. Additionally, the shift in funding for the Prevention and Public Health Fund could impact various public health initiatives.
Potential Benefits
- Prevents discrimination in healthcare based on age, disability, or terminal illness.
- Ensures that all patients receive equal consideration in coverage and payment determinations.
- May lead to increased access to innovative treatments for elderly, disabled, and terminally ill patients.
- Could foster greater trust in the healthcare system by eliminating potentially biased metrics.
- Provides additional oversight through mandated reports on the impact of QALYs.
Most Benefited Areas:
Potential Disadvantages
- May lead to inefficient allocation of healthcare resources by disregarding cost-effectiveness.
- Could result in higher healthcare costs if treatments with lower QALY scores are prioritized.
- May hinder the adoption of evidence-based practices that rely on QALYs for resource allocation.
- Could reduce funding for preventative health programs due to reallocation of funds.
- May create uncertainty in the healthcare industry regarding coverage and payment determinations.
Most Disadvantaged Areas:
Constitutional Alignment
The bill aligns with the general welfare clause of the Constitution (Preamble) by aiming to protect vulnerable populations' access to healthcare. However, the specific provisions regarding healthcare resource allocation are subject to interpretation and debate. The bill does not appear to infringe upon any specific constitutional rights or liberties.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).