Empowering Patients First Act of 2015

Empowering Patients First Act of 2015

This bill repeals the Patient Protection and Affordable Care Act and the health care provisions of the Health Care and Education and Reconciliation Act of 2010, effective as of their enactment. This bill replaces those provisions with amendments to the Internal Revenue Code, the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 (ERISA) to address health care coverage.

The bill provides for refundable tax credits for health insurance coverage and health savings account (HSA) contributions.

The bill raises the annual HSA contribution limit, expands eligibility for tax-deductible HSA contributions, and allows HSAs to be used to pay periodic or capitated primary care fees.

A limit is placed on the amount of an employer's contribution to health coverage that can be excluded from the employee's taxable income.

The Department of Health and Human Services (HHS) must provide a grant to each state for high-risk pools or reinsurance pools to subsidize health insurance for high-risk populations and individuals.

Funds authorized, tax credits, and tax deductions under this Act may not be used to pay for an abortion or health coverage that includes abortion, with exceptions.

This bill provides for the establishment and governance of independent health pools, entities that form risk pools to offer health insurance coverage to their members.

Small Business Health Fairness Act of 2015

This bill provides for the establishment and governance of association health plans, which are group health plans sponsored by business associations that meet certain ERISA certification requirements.

Health insurers offering individual coverage may deny coverage to an individual, outside of open enrollment periods. Preexisting conditions may be excluded from coverage under certain conditions.

Individual health insurance coverage is governed by the laws of a state designated by the health insurance issuer.

HHS must issue clinical practice guidelines. The bill specifies how these guidelines may be used in a health care lawsuit.

HHS may not use comparative effectiveness research or patient-centered outcomes research to deny coverage of an item or service under a federal health care program.

This bill amends title XVIII (Medicare) of the Social Security Act to permit Medicare beneficiaries to contract with a physician or practitioner for covered health care and submit a claim for payment under Medicare.

Health care professionals are exempted from federal and state antitrust laws in connection with negotiations with a health plan to provide health care items or services.

Written by the nonpartisan Congressional Research Service. All summary versions on Congress.gov