I 118th CONGRESS 1st Session H. R. 2857 IN THE HOUSE OF REPRESENTATIVES April 25, 2023 Mrs. Spartz introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To direct the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services to conduct an annual study on health care competition and consolidation at the State level.

1. Short title This Act may be cited as the Measuring State Healthcare Freedom Act . 2. Annual study on health care competition and consolidation at State level (a) In general Over each of the 10 years following the date of enactment of this Act, the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services (in this section referred to as the Assistant Secretary ) shall conduct a study on health care competition and consolidation at the State level. (b) Consultation In conducting the study under this section, the Assistant Secretary shall consult with the Chair of the Federal Trade Commission and the Assistant Attorney General in charge of the Antitrust Division of the Department of Justice. (c) Obtaining data The Assistant Secretary may secure from the Federal Trade Commission information necessary to enable the Assistant Secretary to carry out subsection (d)(2). Upon request of the Assistant Secretary, the Chair of the Federal Trade Commission shall furnish that information to the Assistant Secretary. (d) Metrics The study under this section shall include data collection on each of the following: (1) Licensing requirements for doctors, nurses, and other health care practitioners, including requirements with respect to— (A) initial licensure; (B) ongoing maintenance of licensure; (C) specific training and postgraduate and continuing medical education; (D) residency supervisory requirements; and (E) board certification. (2) Mergers and acquisitions (both vertical and horizontal), involving— (A) hospitals; (B) ambulatory or outpatient practices; (C) ambulatory surgical centers; (D) health insurance providers; (E) habilitative service providers (such as providers of physical therapy or occupational therapy); and (F) telehealth. (3) The number of— (A) State laws establishing a legal mechanism by which a State approves mergers between or among two or more hospitals (commonly referred to as certificates of public advantage ); and (B) State laws establishing a legal mechanism for regulating the growth of construction of new health care facilities (commonly referred to as certificates of need ). (4) The availability of alternative forms of health insurance coverage, including— (A) short-term limited duration insurance (as defined for purposes of section 2791(b)(5) of the Public Health Service Act ( 42 U.S.C. 300gg–91(b)(5) )); and (B) association health plans (including plans offered through the American Farm Bureau Federation). (5) The number of each of the following in operation at the start and the end of each year covered by the 10-year study period: (A) Hospitals. (B) Medical practices. (C) Ambulatory or outpatient practices. (D) Ambulatory surgical centers. (E) Health insurance providers. (F) Habilitative service providers. (6) The Herfindahl-Hirschman Index, within geographic areas defined by the Assistant Secretary in consultation with the Bureau of Competition of the Federal Trade Commission, for the following health care services: (A) General acute care hospital services. (B) Ambulatory or outpatient medical services, disaggregated by medical specialty. (C) Habilitative services. (e) Annual reports (1) In general Not later than the end of each of the 10 years referred to in subsection (a), the Assistant Secretary shall submit to the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives and the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate a report on the status and results of the study under this section. (2) Publication; publicly accessible datasets Not later than the end of each of the 10 years referred to in subsection (a), the Assistant Secretary shall— (A) publish on the website of the Office of the Assistant Secretary the report submitted under paragraph (1) for the respective year; and (B) make the data collected through the study under this section available to the public on such website in a manner that is publicly accessible and interactive.