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Direct Primary Care Bill Advances

A bill allowing patients and doctors to enter into primary care agreements has moved forward. These "direct primary care" agreements generally involve monthly payments between patients -- or patients' employers -- and their doctors. They cover routine medical care without involving insurance companies.

Lawmakers amended the terms of bill Tuesday, clarifying that the agreements are not considered insurance and don't fulfill workers compensation requirements. They are also not subject to the same regulations as insurance.

Sen. Tom Lee of Brandon said that, in a challenging the health care climate, consumers would benefit from additional options. 

“We can’t provide enough options and enough flexibility to consumers to contract the kind of services that are unique to their family’s experience," Lee said. "I think this is another tool in the tool kit.” 

David McKalip, a St. Petersburg neurosurgeon, said the agreements favor the poor and the uninsured by removing roadblocks to healthcare. 

“Direct primary care practices offer low monthly memberships in the range of 25 to 80 dollars a month to reach doctors regularly by cell phone and by internet and in their offices," McKalip said. "They can see patients easily, and patients can spend a great deal of time with them, often having access to discounted lab and imaging services. 

“This bill would insure that such arrangements are not called insurance, and that we don’t have any sort of problems with this sort of arrangement between patient and doctors.”

He also defended the distinction between insurance policies and primary care agreements.  

“Some say, ‘Why not call this insurance?'" McKalip said. "But I pay a retainer to my lawyer. I pay a retainer to my accountant. I pay a health club membership. None of that is insurance." 

Tim Nungesser of the National Federation of Independent Businesses offered his support of the bill.

“I wanted to talk about three things that small business owners are looking for in healthcare. The first one is predictability in the market. This bill satisfies that test. They’re looking for flexibility. And they’re looking for affordability.”  

The bill, SB 240, received unanimous support from the Senate Committee on Banking and Insurance, and was filed for the legislative session that starts March 7th. Last year, the bill was approved by the House in 2016 but did not pass the Senate.  

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Carson covers military and veteans issues for KSTX, the Texas Public Radio station in San Antonio.