Introduction of the Ideal Act

Floor Speech

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Mr. BLUMENAUER. Mr. Speaker, today I am pleased to introduce the Incentivizing Dual-Eligible Alignment (IDEAL) Act.

This legislation seeks to better coordinate and improve care for dual beneficiaries enrolled in integrated special needs plans (D-SNPs). Highly integrated D-SNPs (HIDE SNPs) and Fully Integrated D-SNPs (FIDE SNPs) already manage dual beneficiaries' Medicare and Medicaid benefits, and this legislation will improve their ability to deliver needed services.

First, this legislation creates a pilot program to give Safety Net Health Plan HIDE and FIDE SNPs a rebate to provide services related to social determinants of health. We all know that a person's health is affected by far more than what happens in a doctor's office. If plans can deliver services like meals for people with chronic conditions, rental assistance, and pest eradication, they can address all the factors that contribute to the health of their beneficiaries. This five-year pilot can help inform future policy decisions as Congress weighs how to better improve outcomes. Second, this legislation provides regulatory flexibility to states to align administrative processes between Medicare Advantage and a state's Medicaid plan, allowing the Centers for Medicare and Medicaid Services and states to determine better ways to coordinate care for HIDE and FIDE SNP enrollees.

Fundamentally, the way we approach our health care system needs to change. The United States spends nearly one-fifth of GDP on health care and more per person than other economically comparable countries yet has lower life expectancy. I'm grateful for organizations like Care Oregon that provide care to my constituents and try to challenge the status quo. The federal government must be a partner in delivering care in better, innovative ways, and I believe the policies proposed here can be a part of that.

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