Most states are winding down their legislative sessions. Fortunately DPC laws passed in Wyoming and Nebraska. Other proposals lost steam at some point in the legislative process. Florida and Georgia made it further than most. Alaska never gained traction at the committee stage. Things look very promising in Tennessee where Governor Bill Haslam is expected to sign the legislation. Virginia is a different story where it is anticipated that Governor Terry McAuliffe will not sign the bill. Hopefully we will not face any additional Montana scenarios. When it comes to DPC ignorance is not bliss. We could go 2/7 or 4/7 this session - it's up to the governors now.
Congratulations to Nebraska! Legislative Update
Yesterday Nebraska became the 16th state to pass DPC legislation! See the Nebraska page for more details. As of today we do not have any Nebraska practices in the mapper, but this should change soon!
We are still waiting on legislative outcomes in Virginia (where DPC legislation has passed the House and Senate and rests with the governor) and Tennessee (where legislation is cruising through the committee stages). Florida, Georgia, and Alaska legislative proposals have lost steam and are unlikely to regain attention in this legislative session. An earlier blog post offers links to each state's proposed legislation.
West Virginia's Clueless DPC Resolution
Below I have copied and pasted a new resolution related to DPC in its entirety:
HOUSE CONCURRENT RESOLUTION 106
(By Delegates Waxman, Ellington, Summers, B. White, Stansbury, Atkinson and Campbell)[Originating in the Committee on Health and Human Resources; Reported March 8, 2016]
Requesting the Joint Committee on Government and Finance to study direct primary care.
WHEREAS, Direct primary care is primary care offered directly to the consumer without insurance administration, incorporating various health care delivery systems that involve direct financial relationships between patients and health care providers; and
WHEREAS, Direct primary care is intended to remove many of the financial barriers of healthcare, often, there are no insurance co-pays, deductibles or co-insurance fees thus avoiding the overhead and complexity of maintaining relationships with insurers; and
WHEREAS, A provision of the Patient Protection Affordable Care Act (PPACA) in Section 1301 (and amendment Section 10104) allows for direct primary care to compete with traditional health insurance options in the mandated health insurance exchange when combined with a low cost high deductible plan; and
WHEREAS, Direct primary care practices do not typically accept insurance payments, thus avoiding the overhead and complexity of maintaining relationships with insurers; and
WHEREAS, Because direct primary care payments are typically paid over time, rather than in return for specific services, the economic incentives are such that the long-term health of the patient can be a profitable option for providers while also being an affordable option to patients; and
WHEREAS, West Virginia currently does not authorize direct primary care; therefore be it
Resolved by the Legislature of West Virginia: (Pay attention to your own laws! West Virginia was the first state to carve out a legal path for DPC -albeit an awful one with so many restrictions I would not recommend anyone pursue DPC in West Virginia.)
That the Joint Committee on Government and Finance is hereby requested to study the potential benefits of authorizing direct primary care in West Virginia as an alternative for those citizens who do not qualify for Medicaid and are unable to afford health insurance; and, be it
Resolved by the Legislature of West Virginia:
That the Joint Committee on Government and Finance shall consult with the State Medical Board, the Insurance Commission, the Health Care Authority, medical providers, health insurers and any other relevant groups or entities in gathering and reviewing information regarding direct primary care; and, be it
Further Resolved, That Joint Committee on Government and Finance report to the regular session of the Legislature, 2017, on its findings, conclusions and recommendations, together with drafts of any legislation necessary to effectuate its recommendations; and, be it
Further Resolved, That the expenses necessary to conduct this study, to prepare a report and to draft necessary legislation be paid from legislative appropriations to the Joint Committee on Government and Finance.
To this proposal I have the following response: Dear Joint Committee on Government and Finance. Please save your limited time and resources. Other than the handful of (Vic Wood, DO's) practices listed in the mapper, there really are not any West Virginia DPC practices to study. Your bad DPC law has prevented further growth. There are plenty of academic resources (and nonacademic white papers - if you prefer) that demonstrate the need for DPC and evidence in favor of DPC. Replace your terrible and restrictive law with something real - I've detailed all the problems on the West Virginia page.
Phil Eskew