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Bill

HR 7145

To amend title XIX of the Social Security Act to establish a definition of essential health system in statute and for other related purposes.

119th Congress Introduced by Troy Carter and 6 co-sponsors

Bill establishes federal statutory definition of "essential health system" for Medicaid to create uniform coverage standards across states.

Introduced in House
1
WeVote Research Nonpartisan
Bill Summary · HR 7145

Legislative bill overview

HR 7145 proposes to amend Medicaid (Title XIX of the Social Security Act) by establishing a statutory definition of "essential health system." The bill aims to create consistent federal criteria for what constitutes an essential health system, likely to clarify coverage obligations and service requirements under Medicaid programs.

Why is this important

Medicaid serves over 70 million Americans, and defining essential health systems in statute would establish uniform standards across states rather than relying on regulatory guidance or state interpretation. This could affect healthcare access, coverage determinations, and federal-state responsibilities regarding which health services and providers must be included in Medicaid networks.

Potential points of contention

  • Federalism concerns: Whether federal statutory definition overrides state flexibility in designing Medicaid programs, which traditionally have significant state discretion
  • Definition scope: What services, providers, and facilities qualify as "essential" could either expand or restrict coverage, affecting both beneficiaries and healthcare costs
  • Implementation costs: Establishing uniform standards may require states to restructure existing systems, potentially increasing state budget obligations or federal spending

Compiled from official sources — confirm details with the bill’s official record.

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