You know this one from your own life. The treatment your doctor ordered, denied by someone who never met you. The bill that arrived anyway. The drug that costs $30 in Toronto and $300 here. The bankruptcy that came from getting sick. This statute ends it: prior authorization abolished, surprise bills prohibited, algorithmic denials banned — and executives held personally liable when a denial kills someone.
Your doctor ordered the treatment. A clerk — or an algorithm — at an insurance company overruled them, and you found out by mail. People died waiting for an appeal.Check it
The same drug cost $30 in Toronto and $300 here, because we were the only rich country that refused to negotiate.Check it
You did everything right, went to an in-network hospital, and got a surprise bill from an out-of-network anesthesiologist you never chose. Medical debt became the leading cause of bankruptcy in the richest country on earth.Check it
And when a denial killed someone, nobody was ever held responsible. It was a business decision.Check it
Prior authorization is dismantled on a three-tier framework. Algorithmic denial is prohibited — a human being must review, and a doctor’s judgment stands.
The National Healthcare Cost Board negotiates drug prices with real authority. Flat copays, tiered subsidies, and the PBM middleman is abolished.
Surprise billing is prohibited outright. One single billing system. Medical debt protections. Guaranteed coverage — pre-existing conditions can never be used against you again.
And a two-track liability system: civil and criminal. When an executive’s denial kills a patient, that is not a business decision anymore.
Insurers made you ask permission for care your doctor already prescribed — and delay itself was the profit strategy. People deteriorated and died inside the appeals process.Check it
A three-tier framework dismantles it, and abolition has teeth because executive liability is real. The clinical judgment of the person who actually examined you is the one that governs.
Software auto-denied claims in bulk, at rates no human could have reviewed, and the denial letter arrived with a doctor’s name it had never consulted.Check it
Algorithmic denial is prohibited, with mandatory human review and independent external appeals. A machine does not get to end your treatment.
Americans paid many times what every other country paid for identical drugs, and Medicare was forbidden by law from negotiating.Check it
The National Healthcare Cost Board negotiates with genuine authority, on a differentiated premium structure. Patients get flat copays and tiered subsidies — and the Pharmacy Benefit Manager, the middleman that skimmed from every prescription, is prohibited.
Surprise out-of-network charges, incomprehensible billing, and prices nobody could learn in advance — then debt collectors and bankruptcy.Check it
Surprise billing is prohibited. A single billing system replaces the maze. Price, ownership, and financial transparency are mandatory — and medical debt protections mean getting sick no longer means losing everything.
A pre-existing condition, or losing your job, could cost you your coverage exactly when you needed it most.Check it
Guaranteed coverage with permanent pre-existing condition protection, continuation of employer coverage after job loss, and Medicare buy-in at 60. Coverage stops depending on your employer’s goodwill.
Private equity owners and corporate managers overrode physicians, and hospital consolidation left whole regions with no alternative.Check itCheck it
Corporate control of medical decisions is restricted — the doctor decides, not the owner. Hospital antitrust enforcement breaks the local monopolies that made refusal impossible.
"Parity" was a word on paper: separate deductibles, separate visit limits, separate authorization hoops.Check it
Full parity, stated concretely: no separate deductible, no separate visit limit, no separate prior authorization. Mental health and substance use care are simply care.
A wrongful denial that ended a life produced, at most, a lawsuit the company had already priced in.Check it
A two-track civil and criminal liability system reaching the executives responsible. The overhead cap, public option, cost board, and liability regime are one interlocking machine — assembled as a single statute precisely so they cannot be gutted one at a time. They stand or fall together.
“Covered” meant whatever your plan decided to include this year — with carve-outs, exclusions, and a fine-print list of what it wouldn’t pay for. What you got depended on what you could afford.Check it
A defined basket of care is guaranteed to everyone: all medically necessary hospital and outpatient care, prescription drugs, mental health and substance-use treatment at full parity, preventive care at zero cost, maternity and newborn care, emergency services, rehab, labs, pediatric care, and the full range of reproductive healthcare. Not a plan’s menu — a constitutional floor.
If your employer didn’t offer coverage and you didn’t qualify for a program, the private market was the only door — take its prices or go without.Check it
A public option exists in every state, run as a not-for-profit public benefit corporation. Anyone can buy in. It doesn’t answer to shareholders, and it’s there whether or not a private insurer wants your business.
The gap between losing employer coverage in your early 60s and reaching Medicare at 65 was a well-known danger zone — the years people delayed care or went broke waiting to age in.Check it
Anyone 60 to 64 can buy into Medicare on a sliding scale — free below 138% of the poverty line, full cost only for high earners. Same network, same care as Medicare itself. The gap is closed.
A terminally ill person facing months of suffering had no lawful, dignified choice in most of the country — and where one existed, it could be revoked by the next legislature.Check it
Medical aid in dying is protected for terminally ill, mentally competent adults, with strong safeguards — two independent physicians, confirmed prognosis, waiting periods, competency review. States can regulate it but can’t ban it.
This is the plain-language version. The binding text is CS-3, which implements Right 37 and Article Eleven of the Constitution.
This is your country’s law. Help shape the next draft of it.
