H.R.3263 - Protecting Access To Care in Hawaii Act; PATCH Act (119th Congress)
Summary
H.R.3263, also known as the PATCH Act, aims to amend Title XVIII of the Social Security Act. The bill seeks to establish a floor on the work geographic index (WGI) for physician services in Hawaii. Specifically, it mandates that the Secretary increase the WGI to 1.5 if it falls below that level, starting January 1, 2026, and stipulates that this adjustment should not be budget neutral.
Expected Effects
The bill's primary effect would be to increase Medicare payments to physicians in Hawaii. This is intended to improve access to care by making it more financially viable for physicians to practice in the state. The non-budget neutral aspect suggests that the increased payments will not be offset by reductions elsewhere in the Medicare program.
Potential Benefits
- Improved Healthcare Access: By increasing physician reimbursement rates, the bill aims to attract and retain doctors in Hawaii, ensuring residents have better access to medical care.
- Financial Stability for Physicians: The higher WGI floor provides a more stable and predictable income for physicians, potentially reducing financial pressures that might lead them to leave the state.
- Specialized Care Availability: Increased reimbursement may incentivize specialists to practice in Hawaii, reducing the need for patients to travel to the mainland for specialized medical services.
- Economic Boost for Healthcare Sector: The increased federal funding flowing into Hawaii's healthcare sector could stimulate economic activity within the state.
- Focus on a Specific Geographic Need: The bill directly addresses a specific healthcare challenge faced by Hawaii due to its geographic isolation and associated costs.
Potential Disadvantages
- Increased Medicare Costs: The non-budget neutral nature of the bill means that overall Medicare spending will increase, potentially impacting the program's long-term sustainability.
- Potential for Inequity: Setting a WGI floor for one state could create pressure for similar adjustments in other states, leading to a complex and potentially inequitable reimbursement system.
- Lack of Transparency: The bill does not specify how the increased costs will be absorbed within the Medicare program, raising concerns about potential impacts on other services or beneficiaries.
- Unintended Consequences: Artificially inflating the WGI could distort the market for physician services, potentially leading to inefficiencies or overutilization of certain services.
- Limited Scope: The bill only addresses physician reimbursement and does not tackle other factors that contribute to healthcare access challenges in Hawaii, such as workforce shortages or infrastructure limitations.
Most Disadvantaged Areas:
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution (Preamble). Congress has broad authority to legislate on matters related to healthcare under the Social Security Act. The bill's focus on ensuring access to care in Hawaii could be interpreted as promoting the general welfare. However, the lack of budget neutrality could raise concerns about fiscal responsibility and the potential impact on other states, which might require further scrutiny under the principles of equal protection and fair allocation of resources.
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).