{"format":1,"id":"118-hr-485","congress":118,"number":"H.R. 485","kind":"bill","group":"bills","title":"Protecting Health Care for All Patients Act of 2023","title_source":"Short Title(s) as Passed House","official_title":"To amend title XI of the Social Security Act to prohibit the use of quality-adjusted life years and similar measures in coverage and payment determinations under Federal health care programs.","titles":[{"type":"Official Title as Introduced","title":"To amend title XI of the Social Security Act to prohibit the use of quality-adjusted life years and similar measures in coverage and payment determinations under Federal health care programs."},{"type":"Display Title","title":"Protecting Health Care for All Patients Act of 2023"},{"type":"Short Titles from RFS (Referred to Senate) bill text","title":"Protecting Health Care for All Patients Act of 2023"},{"type":"Short Title(s) as Introduced","title":"Protecting Health Care for All Patients Act of 2023"},{"type":"Short Title(s) as Reported to House","title":"Protecting Health Care for All Patients Act of 2023"},{"type":"Short Title(s) as Passed House","title":"Protecting Health Care for All Patients Act of 2023"}],"outcome":"passed_house","law_number":null,"introduced":"2023-01-24","chambers":{"house":{"status":"roll_call","date":"2024-02-07","vote":{"id":"118-2024-h40","question":"On Passage","title":"Protecting Health Care for All Patients Act","result":"Passed","yea":211,"nay":208,"present":0,"not_voting":11,"source":"https://clerk.house.gov/evs/2024/roll040.xml"}},"senate":{"status":"na","date":null,"vote":null}},"president":{"status":"na","date":null},"vice_president_tie_breaker":null,"latest_action":{"text":"Referred to the Subcommittee on Health.","date":"2024-12-17"},"nominees":null,"amendments":[],"other_votes":[{"chamber":"house","date":"2024-02-07","question":"On Motion to Recommit","title":"Protecting Health Care for All Patients Act","result":"Failed","yea":207,"nay":210,"present":0,"not_voting":14,"kind":"procedural","source":"https://clerk.house.gov/evs/2024/roll039.xml"}],"crs_summary":{"date":"2024-02-07","stage":"Passed House","blocks":[{"k":"h","t":"Protecting Health Care for All Patients Act of 2023"},{"k":"p","t":"This bill prohibits all federal health care programs, including the Federal Employees Health Benefits Program, and federally funded state health care programs (e.g., Medicaid) from using prices that are based on quality-adjusted life years (i.e., measures that discount the value of a life based on disability, age, or terminal illness) to determine relevant thresholds for coverage, reimbursements, or incentive programs."},{"k":"p","t":"The Government Accountability Office must annually report on how the use of quality-adjusted life years negatively affects individuals with intellectual and developmental disabilities."},{"k":"p","t":"The bill also reduces funding for the Prevention and Public Health Fund for FY2024-FY2029."}],"words":106},"summary":{"main_subject":{"text":"Prohibits Federal agencies and States from using dollars-per-quality-adjusted-life-year and similar measures under Federal health care programs, and applies that prohibition to Medicaid, CHIP, Medicare Advantage and Medicare Part D plans.","cites":[{"label":"Sec. 2","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh#H9BDE69999E744372BC467344F396CFFF"}]},"core_areas":["Use of quality-adjusted life year measures in Federal health care programs","Medicaid, CHIP, Medicare Advantage and Medicare Part D plan requirements","Prevention and Public Health Fund amounts","Comptroller General reporting on quality-adjusted life years"],"what_it_does":[{"text":"Amends section 1182(e) of the Social Security Act so that it applies to a Federal agency (including the CMI) or a State, and to any Federal health care program, including the health program under chapter 89 of title 5, United States Code.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh#H9BDE69999E744372BC467344F396CFFF"}},{"text":"Adds to the measures covered by section 1182(e) those that treat extending the life of an elderly, disabled, or terminally ill individual as of lower value than extending the life of a younger, non-disabled, or not terminally ill individual.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh#H9BDE69999E744372BC467344F396CFFF"}},{"text":"Bars a Federal agency (including the CMI) or a State from waiving these provisions under section 1115, section 1115A, or any other demonstration or waiver authority.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh#H9BDE69999E744372BC467344F396CFFF"}},{"text":"Requires Medicaid State plans, Medicaid managed care organizations, State child health plans, Medicare Advantage plans and prescription drug plans to comply with section 1182(e), beginning January 1, 2025.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh#H9BDE69999E744372BC467344F396CFFF"}},{"text":"Amends section 4002(b) of the Patient Protection and Affordable Care Act to set Prevention and Public Health Fund amounts of $1,102,000,000 for each of fiscal years 2024 and 2025, $1,327,000,000 for each of 2026 and 2027, and $1,526,000,000 for each of 2028 and 2029.","cite":{"label":"Sec. 3","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh#H41616E01EC3148F7832FE56FECC956A6"}},{"text":"Requires the Comptroller General to report to Congress within 1 year of enactment, and annually after, on how quality-adjusted life years negatively impacts individuals with intellectual and developmental disabilities and their access to care.","cite":{"label":"Sec. 4","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh#HFC59C4D0B336461D9C8C2E8833869889"}}],"unexpected":[{"category":"named_funding","items":[{"cite":{"label":"Sec. 3","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh#H41616E01EC3148F7832FE56FECC956A6"},"heading":"Prevention and Public Health Fund","effect":"Replaces the Prevention and Public Health Fund appropriation amounts for fiscal years 2024 through 2029, setting $1,102,000,000, $1,327,000,000 and $1,526,000,000 for the paired fiscal years.","amount":null,"quote":"for each of fiscal years 2024 and 2025, $1,102,000,000; (8) for each of fiscal years 2026 and 2027, $1,327,000,000;"}]}],"version":{"type":"Engrossed in House","date":"2024-02-07","rule":"passed","href":"https://www.congress.gov/bill/118th-congress/house-bill/485/text/eh"},"current":true,"model":"claude-sonnet-5-5","approved":"2026-10-01","approved_by":"checks"},"sources":{"congress_gov":"https://www.congress.gov/bill/118th-congress/house-bill/485","text":"https://www.congress.gov/bill/118th-congress/house-bill/485/text"},"card":{"image":"card/item/118-hr-485.png","v":"2d4edc4cb70c","alt":"Votes on Record. H.R. 485, 118th Congress: Protecting Health Care for All Patients Act of 2023. House: 211 Yea, 208 Nay. Outcome: Passed House, 7 Feb 2024."}}