Measuring State Healthcare Freedom Act

Bill Number

H.R. 3017

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-04-24: Referred to the House Committee on Energy and Commerce.

Last Updated

2025-05-21T10:53:00Z

AI-Generated Summary

Purpose

The Measuring State Healthcare Freedom Act (H.R. 3017) aims to increase transparency and understanding of health care competition and consolidation trends at the state level. It directs the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services (HHS) to conduct an annual study over 10 years to track factors that affect market competition in health care, such as licensing rules, mergers, and insurance options.

Key Provisions

• Study Mandate: HHS's Assistant Secretary must perform an annual study for 10 years following enactment, focusing on state-level health care competition and consolidation.
• Consultation and Data Sharing: The Assistant Secretary will consult with the Chair of the Federal Trade Commission (FTC) and the Assistant Attorney General for the Antitrust Division at the Department of Justice (DOJ). The Assistant Secretary can request and receive necessary data from the FTC.
• Metrics Covered in the Study:
• Licensing requirements for health care professionals (e.g., doctors, nurses), including initial licensing, ongoing maintenance, training, residency supervision, and board certification.
• Mergers and acquisitions (both horizontal, between similar entities, and vertical, between different parts of the supply chain) involving hospitals, outpatient practices, surgical centers, health insurers, habilitative service providers (e.g., physical or occupational therapy), and telehealth services.
• State laws on "certificates of public advantage" (approvals for hospital mergers) and "certificates of need" (regulations limiting new health care facility construction).
• Availability of alternative health insurance options, such as short-term limited duration insurance and association health plans (group plans for specific professions or organizations).
• Changes in the number of operating entities, including hospitals, medical practices, outpatient facilities, surgical centers, health insurers, and habilitative providers, measured at the start and end of each year.
• The Herfindahl-Hirschman Index (HHI), a standard measure of market concentration that indicates how competitive a market is (higher scores suggest less competition due to dominance by a few players), calculated for services like general hospital care, outpatient medical specialties, and habilitative services within defined geographic areas.
• Reporting Requirements: By the end of each of the 10 years, the Assistant Secretary must submit a report to key congressional committees (House Energy and Commerce, Ways and Means; Senate Finance, Health, Education, Labor, and Pensions). Reports must be published on the HHS Assistant Secretary's website, and the underlying data must be made publicly available in an interactive, accessible format.

Significant Changes to Existing Law

This bill introduces a new federal mandate for ongoing, systematic data collection and reporting on state-level health care market dynamics. Previously, no such annual, comprehensive study was required by law, though agencies like the FTC and DOJ already monitor antitrust issues in health care. It formalizes interagency collaboration and public data access without altering existing regulations on licensing, mergers, or insurance.

Potential Impacts

• Government Agencies: HHS will bear the primary responsibility for conducting and reporting the studies, increasing administrative workload. The FTC and DOJ will provide consultation and data, potentially enhancing coordination on antitrust enforcement. Congressional committees will receive regular updates to inform oversight and legislation.
• Citizens: The studies could highlight barriers to competition, such as restrictive licensing or mergers, potentially leading to future policies that lower health care costs, improve access to providers, and expand insurance choices. Publicly available data may empower consumers, researchers, and advocates to analyze local markets.
• International Relations: No direct impacts, as the bill focuses exclusively on domestic U.S. state-level health care issues.

Main Stakeholders Affected

• Federal Agencies: HHS (lead role), FTC, and DOJ (supporting data and expertise).
• State Governments: Affected by scrutiny of their licensing laws, merger approvals, and facility regulations; findings could influence state policy reforms.
• Health Care Providers and Insurers: Hospitals, medical practices, outpatient facilities, surgical centers, telehealth operators, habilitative providers, and insurance companies, as their mergers, operations, and market shares will be tracked.
• Health Care Professionals: Doctors, nurses, and other practitioners, due to examination of licensing and training requirements.
• Consumers and Patients: Benefit from greater transparency on competition, which could affect affordability and availability of services.
• Researchers and Policymakers: Gain access to interactive datasets for analysis and evidence-based decision-making.

Notable Legal, Constitutional, or Political Implications

• Legal: The bill strengthens federal oversight of state health care markets without preempting state authority, relying on voluntary data sharing and consultation. It could indirectly support antitrust actions by providing evidence of market concentration via the HHI metric.
• Constitutional: Aligns with Congress's authority to direct executive agencies (like HHS) for studies under the Commerce Clause, as health care is a major interstate industry. No apparent conflicts with federalism, as it studies rather than mandates state changes.
• Political: Promotes bipartisan interest in reducing health care consolidation (often linked to rising costs) by emphasizing "freedom" in markets through competition. Annual reports could fuel debates on deregulation (e.g., easing licensing or certificates of need) or antitrust reforms, influencing future legislation without immediate partisan divides evident in the bill text.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Spartz, Victoria [R-IN-5]

Recent Actions

• 2025-04-24: Referred to the House Committee on Energy and Commerce.
• 2025-04-24: Introduced in House
• 2025-04-24: Introduced in House

Bill Versions

• Measuring State Healthcare Freedom Act — issued 2025-04-24 — PDF (6 pages)