HELENA, Mont. (Jan. 26, 2017) – A bill that would help facilitate healthcare freedom and set the stage to nullify Obamacare in practice in Montana passed an important Senate committee Monday.
Sen. Cary Smith (R-Billings) introduced Senate Bill 100 (SB100) on Jan. 9. The legislation would authorize direct primary care agreements (sometimes called medical retainer agreements) in Montana and exempt them from state insurance regulations. It would effectively ensure direct primary care agreements aren’t treated as insurance, thereby freeing doctors and patients from the onerous requirements and regulations under the state insurance code.
On Jan. 23, the Public Health, Welfare and Safety Committee passed SB100 by a 7-2 vote.
According to Michigan Capitol Confidential, by removing a third party payer from the equation, medical retainer agreements help both physicians and patients minimize costs. Jack Spencer writes:
“Under medical retainer agreements, patients make monthly payments to a physician who in return agrees to provide a menu of routine services at no extra charge. Because no insurance company stands between patient and doctor, the hassles and expense of bureaucratic red tape are eliminated, which have resulted in dramatic cost reductions. Routine primary care services (and the bureaucracy required to reimburse them) are estimated to consume 40 cents out of every dollar spent on insurance policies, so lower premiums for a given amount of coverage are another potential benefit.”
This represents the kind of cost control Obamacare promised, but failed to deliver.
Under Obamacare, regulations define such programs as a primary care service and not a health insurance plan, and current IRS policy treats these monthly fee arrangements just like another health plan.
A FIRST STEP
At this point it remains unclear whether Congress will actually send President-elect Trump a bill to repeal Obamacare. If so, will it be a complete or just a partial repeal? Regardless, state actions can help completely bring down the Affordable Care Act.
Oftentimes, supporters of Obamacare criticize opponents for not having any alternative. Direct primary care offers one.
These direct patient/doctor agreements allow a system uncontrolled by government regulations to develop. It makes doctors responsive to patients, not insurance company bureaucrats or government rule-makers. Allowing patients to contract directly with doctors via medical retainer agreements opens the market. Under such agreements, market forces will set price for services based on both demand instead of relying on central planners with a political agenda. The end-result will be better care delivered at a lower cost.
By incentivizing creative healthcare solutions, the market will naturally provide better options, such as the Surgery Center of Oklahoma, This facility operates completely outside of the insurance system, providing a low-cost alternative for many surgical procedures.
A more open healthcare marketplace within a state will help spur de facto nullification the federal program by providing an affordable alternative. As patients flock to these arrangements and others spurred by ingenuity and market forces, the old system will begin to crumble.
Passage of SB100 would represent a first step toward healthcare freedom in Montana, and would create a stepping stone to further action to nullify the onerous Affordable Care act. Once in place, Montanans can take further steps to fully extricate themselves from Obamacare for good.
SB100 will move to the full Senate for further consideration.
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