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ACA Repeal & Replace Plans Call for One Size Fits All Approach, Caps on Damages

An article posted yesterday on Huffington Post examines how Republicans’ plan to repeal and replace parts of the Affordable Care Act (ACA) will force Americans to be treated as a diagnosis and not an individual with personal or legal rights. This past May, Tom Price, now Trump’s pick for Secretary of Health and Human Services, released the ‘Empowering Patients First Act,’ his alternative to healthcare reform known as the Affordable Care Act.

Price’s plan, known as the Empowering Patients First Act, would require doctors to administer medical treatment for symptoms based on a set of guidelines established by the Secretary of Health & Human Services in conjunction with a currently unidentified  ‘qualified physician census organization.’ According to Price, these clinical guidelines would be updated every two years and would be made available to the public. Should the Empowering Patients First Act pass, Americans would no longer be treated as an individual, but rather as a set of symptoms resulting in a one size fits all diagnosis.

Why Americans Should Worry
In addition to reducing American patients to nothing more than a medical definition found in Price’s clinical guidelines, his Empowering Patients First Act greatly restricts our ability to receive fair compensation if our medical care has been deemed negligent. By requiring physicians to adhere to his established clinical guidelines, doctors would be able to use this as a valid defense in a lawsuit, essentially taking away our right to argue against a misdiagnosis or mistreatment. If a set of symptoms presented as one thing but was, in fact, something entirely different, a physician following the guidelines would be excused from any liability for substandard care.

Just as worrisome is the fact that Price’s plan also calls for health care tribunals in each state. These tribunals would review any medical malpractice case brought forth and render a decision. A tribunal would not be made up by our peers, but instead ‘at least half physicians or health care professionals.’  It is only upon appeal of this decision that a patient (or their surviving family members) could have access to a jury trial.

Repeal and Replace Proposals Based on Faulty Data
What makes the clinical guidelines and health care tribunals even more frightening is that these proposed changes would be combined with caps on damages, something that most Republican lawmakers mistakenly believe drive up health care costs. In the Huffington Post article, author Joanne Doroshow points out that for years, Republicans have been relying on outdated, unreliable statistics from the Congressional Budget Office. Their decade old study suggested that billions would be saved by limiting the amount patients could receive as compensation for instances of medical malpractice. Based on the most current data, Doroshow notes that ‘studies are showing that state limits on patients’ legal rights have no impact whatsoever on insurance rates for doctors, and that in any event, medical malpractice premiums and claims per doctor are now the lowest level in four decades.’

With Trump set to take office in just 10 days and his Secretary of Health & Human Services, Tom Price, ready to start pushing his Empowering Patients First Act forward, we’re certain to be inundated with information from all sides on health care reform. Levin & Perconti will continue to keep you informed of the latest plans to repeal and replace the Affordable Care Act.

To read a summary of the main points of the Empowering Patients First Act, click here.

To read the Empowering Patients First Act in its entirety, please click here.