The Democratic chairs of two influential congressional committees are seeking feedback intended to help them draft legislation to create a public health insurance option, a policy favored by President Joe Biden.
The request for information calls on interested parties to answer a handful of questions centering around how such a government-run plan would work in terms of benefit design and who should be eligible. One line of questioning touches on pricing, a heated topic in American healthcare, especially when it's about who gets to decide prices for hospitals and providers.
"How should prices for health care items and services be determined? What criteria should be considered in determining prices?" the RFI stated.
It's a line of questioning likely to make hospitals and private insurers bristle. Both the American Hospital Association and America's Health Insurance Plans have fiercely opposed and helped quash similar proposals, fearing government competition will drive down prices and profits.
AHA responded to the lawmakers' query Wednesday and said it does not support a public option plan. AHA said it would strip providers of resources due to "inadequate reimbursement rates," and put hospitals at risk of closure.
Larry Levitt, executive vice president of health policy for the Kaiser Family Foundation, noted the query takes on the heart of any proposal.
"One of the trickiest questions: How to determine the prices for doctors, hospitals, and drugs," Levitt said in a tweet following Wednesday's announcement.
While the RFI suggests the Democrats are serious about moving forward, chances seem slim in the near term given the Democrats' tight control of the Senate, where any holdouts hold significant power in killing the effort. Even with all Democrats on board, it would lead to a difficult and complicated passage.
Democrats Frank Pallone, chairman of the House Energy and Commerce Committee and Patty Murray, chair of the Senate Health, Education, Labor, and Pensions Committee, sent out the RFI on Wednesday, requesting responses by July 31.
"We believe bold steps are necessary in order to achieve universal coverage and lower health care costs," the RFI from the two Democratic chairs reads.
A public option plan was batted about during the construction of the Affordable Care Act, but it was ultimately nixed in order to get the landmark legislation passed.
Since then, states have attempted to pass their own versions, and for politicians like Biden it's viewed as a more moderate change than an industry-altering "Medicare for All" system.
A majority of voters support a public option plan, according to a recent poll from Morning Consult that showed seven in 10 voters support such a measure, beating out support for Medicare for All.
After a steady decline in the number of uninsured Americans since the passage of the ACA, that figure started to rise again in 2017, according to KFF. There are now about 30 million uninsured in the U.S.
Although Biden has worked to decrease the rate of the uninsured by reopening the ACA marketplaces for a special period during the COVID-19 pandemic, millions are still without insurance. The lawmakers argue a public option could help reverse this trend.