H.R.639 - Doctor Knows Best Act of 2025 (119th Congress)
Summary
H.R.639, the "Doctor Knows Best Act of 2025," aims to prohibit prior authorization requirements, utilization management techniques, and medical necessity reviews by group health plans, health insurance issuers, and Federal health care programs. The bill amends the Public Health Service Act and the Social Security Act to achieve this goal. It intends to give doctors more autonomy in treatment decisions.
Expected Effects
If enacted, this bill would likely lead to doctors having greater freedom in prescribing treatments and services. Insurers and federal healthcare programs would be restricted from using prior authorization and other utilization management tools. This could potentially increase healthcare costs and utilization.
Potential Benefits
- Increased Doctor Autonomy: Physicians have more control over treatment plans.
- Reduced Administrative Burden: Doctors and patients face fewer bureaucratic hurdles.
- Faster Access to Care: Patients may receive necessary treatments more quickly.
- Potentially Better Patient Outcomes: Doctors can make decisions based solely on patient needs.
- Simplified Healthcare Process: Streamlines the process for both providers and patients.
Most Benefited Areas:
Potential Disadvantages
- Increased Healthcare Costs: Unfettered access to services could drive up costs.
- Potential for Overutilization: Doctors might prescribe unnecessary treatments.
- Risk of Inappropriate Care: Lack of oversight could lead to suboptimal treatment decisions.
- Financial Strain on Healthcare System: Increased costs could burden taxpayers and insurers.
- Inconsistency in Care Standards: Without utilization management, care might vary widely.
Constitutional Alignment
The bill's constitutional alignment is complex. Congress has the power to regulate interstate commerce, which includes health insurance (Article I, Section 8). However, the extent of federal intervention in healthcare is often debated. The bill does not appear to infringe on individual rights explicitly protected by the Constitution, such as those in the Bill of Rights. The role of the federal government in healthcare is a long-standing debate.
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).