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S. 1033 (116th): Consumer Health Options and Insurance Competition Enhancement Act

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The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Apr 4, 2019.

Consumer Health Options and Insurance Competition Enhancement Act or the CHOICE Act This bill requires the Centers for Medicare and Medicaid Services (CMS) to develop a public health insurance option that meets all federal plan requirements and is available on state and federal health insurance exchanges. Specifically, the CMS must offer silver and gold plans, may offer bronze plans, and must include all essential benefits, consumer protections, and cost-sharing limitations in each plan. The CMS may contract with a third party to administer the public option plans and states may establish advisory councils to make recommendations to the CMS about the operation and policies of such plans. Further, the CMS must establish geographically adjusted premiums and negotiate provider payment rates for services and prescription drugs covered the plans. If a payment rate cannot be negotiated, the CMS must pay the amount for such service as required under traditional Medicare. Medicare and Medicaid providers are automatically participants in public option plans unless they opt out, and providers not participating in Medicare or Medicaid may opt in.