Republican Rep. Dan Crenshaw (Texas) will introduce legislation on Thursday aimed at expanding the use of a health care payment model that forgoes traditional insurance for Medicaid recipients, in the hopes that patients can receive more regular primary care.
The bill, titled the “Medicaid Primary Care Improvement Act,” would essentially give state Medicaid programs explicit permission to employ a payment model known as direct primary care for Medicaid beneficiaries.
What is it: Direct primary care is an umbrella term for payment models in which primary care physicians don’t bill patients’ insurance companies and instead accept a flat monthly fee.
Proponents for this model argue it allows providers to give more personalized care, allowing them to spend more time with patients while reducing burnout since they see fewer individuals.
Critics have pointed out that patients could pay more in this model as they may still require traditional insurance to see specialists and monthly membership fees aren’t feasible for everyone.
The bill from Crenshaw seeks to clarify that nothing in XIX of the Social Security Act strictly prohibits states from providing medical assistance through the use of direct primary care models.
In a statement to The Hill, Crenshaw’s office said primary care physicians reduce the use of emergency rooms, improve health outcomes and potentially reduce overall health costs.
They further noted that emergency room visits are a common driver of costs for Medicaid recipients.
Crenshaw is introducing the bill alongside Democratic Rep. Kim Schrier (Wash.).
