From: The Honorable Randy Hultgren
Sent By:
Bill: H.R. 3352
Date: 7/30/2015

Dear Colleague,
I have introduced H.R. 3352, the State Health Care Options Act of 2015 (SHOA), to offer states real flexibility to implement free-market health insurance alternatives that make true affordability achievable. The Patient Protection and Affordable Care Act (ACA) was written, passed, and implemented under the premise that centralizing authority over Americans’ health care within the federal government would improve access to coverage and drive down insurance costs. In the years since the ACA went into effect, consumers have seen their premiums, deductibles, and out-of-pocket costs rise, a trend that isn’t slowing down anytime soon.
Late this spring insurers across the country started announcing their intention to significantly increase health insurance rates for next year, including a possible 30 percent increase in premiums for many plans in my home state of Illinois. Not surprisingly, these new costs are limiting access. The number of underinsured Americans – those consumers who have been priced out of sufficient health coverage – now stands at 31 million. Anticipated premium increases next year, in addition to the ongoing consolidation of the United States health insurance market, demonstrate the need for a mechanism through which states can chart their own course, away from a law that is not living up to its promises.
SHOA revamps section 1332 of the ACA to streamline and expand the process and parameters for state innovation waivers, which were made functionally inaccessible by over-the-top rules from the Centers for Medicare and Medicaid Services. The federal government has tried this before – successfully. The No Child Left Behind Act (NCLB) left states with one-size-fits-all standards to improve and assess their unique school systems. Forty-five states said they could do it better, and the Department of Education let 43 states and the District of Columbia give it a try, offering state educational agencies the independence and flexibility to request waivers for 10 provisions of NCLB. Similarly, SHOA would create a new pathway allows states to waive the ACA’s restrictive benefit and plan requirements and/or opt out of the law’s insurance exchange provisions.
In addition to freeing up states to foster health insurance markets that better serve their residents, the bill reforms ACA subsidies, making them available to individuals and families in waiver states living at or below 300 percent of the federal poverty level. SHOA also creates a new “no lock-out” provision that gives Americans in waiver states who experience changes to their income, employment status, and/or health to smoothly and lawfully make a health plan change irrespective of the national open enrollment date.
Please join me in granting states a clear, direct path toward viable, more suitable free-market ACA alternatives. States have independently produced and tested successful approaches to countless national problems – health insurance should be no different.
If you have any questions or wish to be added as a cosponsor, please contact Elise Tollefson. She can be reached at or 202-225-2976.
Randy Hultgren, Member of Congress