Democrats are laying the groundwork for their next healthcare overhaul if they take control of Congress in this fall’s elections. A new report from the Center for American Progress, titled “A Patient’s Bill of Rights for Lowering Health Costs,” outlines a sweeping set of reforms intended to reduce premiums, deductibles, and insurance denials.
The proposal includes capping premium increases by barring insurers from raising rates beyond underlying cost growth without regulatory approval. Critics argue this could drive insurers out of the market, as happened after Obamacare imposed similar restrictions in some regions where patients were left with only one insurance option.
Additionally, the report calls for capping hospital prices at no more than three times Medicare rates in “concentrated” markets and requiring insurers to pass savings through lower deductibles. However, experts warn that price caps do not necessarily reduce costs: hospitals may delay investments or close facilities, resulting in longer wait times and fewer options.
The Center for American Progress also targets so-called “transfer pricing,” a practice used by vertically integrated firms like health insurers that own physician groups and pharmacies. Under Obamacare’s medical loss ratio rules, such transactions count as medical spending even though the funds do not leave the company, allowing insurers to maintain high profits without reducing costs. The report recommends banning these internal transactions from premium calculations.
This approach fails to address the root cause of the problem: the current system rewards inefficiency over cost savings. Insurers have found ways to game the rules while maintaining profitability, and similar issues plague other proposed reforms like prior authorization systems that shift decision-making away from patients and doctors.
