PA 6 District Campaign-Series 3 Questions, Chrissy Houlahan & Marty Young

Dear Colleagues:

        In an effort to help our local politicians understand the importance of health care in this election, the CCMS and UPG have developed a series of questions that we are sending to the politicians running for office in PA District 6.  These questions will be sent the beginning of the month and the candidate will be given a deadline to respond.  The answers from the candidates will be forwarded to CCMS /UPG members unreacted nor edited.  If a candidate does not respond then the "Candidate did not provide a response" will be noted. It is not the intention of CCMS/UPG to endorse one candidate over another but to ask each candidate a series of questions about healthcare and for you as members to contemplate their responses. We hope you find this helpful. Below please fine the answers to the first series of questions.

- Drew Murphy MD Chair of Advocacy

Chrissy Houlahan: We are a small campaign team and Chrissy is now in her fourth term with a very

established legislative record and continues to be present and accessible in the

community. We believe her actions speak volumes about the way she serves our

community and the values she leads with in Congress. Her voting record is available on

her official website, along with press releases, her social media accounts, and her

newsletters. With that in mind, we have made the decision to not participate in

questionnaires on any topic in this cycle.

Please access Chrissy’s priorities and accomplishments on her website: houlahan.house.gov

Marty Young:

Thank you for the opportunity to continue this important dialogue with the Chester County Medical Society. Building on my May, June, and July 2026 responses regarding structural challenges facing physicians—including workforce constraints from the 1997 Balanced Budget Act, MACRA/MIPS administrative burdens, restrictions on physician-owned hospitals, site- neutral payment reform, prior-authorization overhaul, and the need to expand TRICARE-style transparency, rates, rules, and forms across all federal program—I remain fully committed torestoring physician autonomy, dramatically reducing regulatory and documentation burdens, and supporting sustainable independent practices. These reforms are foundational to the success of

my Young Americans Healthcare Plan (YAHP), which leverages the efficient TRICARE model to deliver affordable coverage for children, young adults up to age 23, and expectant mothers while strengthening the delivery system physicians and patients rely upon.

I have heard consistently from physicians across Chester County about the pressures of declining access, rising costs for families, and the administrative weight that falls disproportionately on independent practices. My proposals draw from my experience as a turnaround executive who has eliminated administrative bloat in complex organizations and as a career Army Officer who

is intimately familiar with TRICARE. Below are my specific, actionable answers.

1. How would you expand access to affordable care while avoiding further administrative complexity or unintended strain on physicians and medical practices? Please identify specific policy approaches.

Expanding access and affordability must not come at the cost of adding new layers of bureaucracy that pull physicians further from patients or accelerate consolidation. The path forward is to leverage proven, lower-overhead models and remove the distortions that currently disadvantage independent practices.

I would prioritize these concrete approaches:

a. Launch and scale the Young Americans Healthcare Plan (YAHP) on the TRICARE platform.

YAHP would extend TRICARE-modeled coverage—known for significantly lower administrative overhead, standardized processes, and proven cost discipline—to children, young adults through age 23, and expectant mothers. By using existing TRICARE rates, rules, forms, and authorization infrastructure rather than creating a new parallel bureaucracy, we expand coverage for the next generation of American families while reducing, not increasing, administrative complexity for physicians. This stabilizes family budgets, ends medical bankruptcies for young families, and strengthens the independent practices that serve them.

b. Standardize reimbursement and administrative processes across all federal programs on the TRICARE model.

Direct CMS to adopt TRICARE’s rates, rules, forms, and prior-authorization processes as the standard for Medicare, Medicaid, the Federal Employees Health Benefits Program, and other federally funded coverage. This single structural reform delivers site-neutral payments (ending the differential that incentivizes hospital outpatient consolidation), predictable and adequate reimbursement for independent practices, and a dramatic reduction in the variation and volume of documentation requirements. Physicians would no longer navigate multiple incompatible systems from the same ultimate payer—the federal government.

c. Reform prior authorization and utilization management system-wide without new reporting mandates.

Mandate gold-carding for high-performing independent physicians, standardized electronic forms and clinical criteria (using the TRICARE template), strict response timelines with automatic approval for non-response, and public transparency of denial rates and criteria. These changes free physician and staff time for patient care while preserving legitimate cost control—avoiding the creation of yet another complex quality or value program that adds compliance theater.

d. Empower patients and support direct physician-patient arrangements.

Accelerate robust price transparency, expand Health Savings Accounts with higher contribution limits and incentives for preventive care, and protect and support Direct Primary Care (DPC) and membership models (such as MDVIP-style arrangements) that allow patients and physicians to contract directly for routine care, bypassing layers of insurance administration. Pair these with standardized TRICARE-rate coverage for broader needs. This restores the authentic physician-patient relationship and reduces strain on practices.

e. Address underlying cost drivers and workforce constraints without new mandates.

Advance comprehensive PBM reform (requiring pass-through pricing and banning spread pricing), 340B reforms that eliminate distortions favoring large consolidated entities, and strengthened antitrust scrutiny of hospital acquisitions of physician practices. Simultaneously, lift the outdated 1997 Balanced Budget Act caps on Medicare-funded residency positions and create incentives for medical schools to control administrative costs so more physicians can enter primary care and independent practice. These steps expand supply and lower system costs without imposing new documentation or reporting burdens on practicing physicians.

Taken together, these approaches expand affordable coverage and access by simplifying and standardizing rather than layering on complexity, preserving the viability of independent medical practices that are essential to community access in Chester County and beyond.

2. What is your view on the growth of Medicare Advantage and its impact on traditional Medicare, patient access, and practicing physicians? What policy changes, if any, would you support?

Medicare Advantage now covers roughly 55 percent of eligible beneficiaries—more than 35 million people. Many enrollees value the supplemental benefits, out-of-pocket protections, and care coordination these plans can offer. At the same time, the program’s rapid growth has created real strains on traditional Medicare, on patient access in some communities, and on the independent physicians who still deliver a large share of care.

Key challenges include:

 Federal spending and traditional Medicare: MedPAC estimates that Medicare currently pays Advantage plans about 14 percent more per enrollee than it would spend for comparable beneficiaries in traditional Medicare roughly $76 billion in additional spending in 2026. Favorable selection and coding intensity contribute to this gap. As a result, traditional Medicare’s remaining risk pool becomes relatively more expensive, which pressures the program’s long-term finances and the physicians who continue to serve those patients.

 Patient access: Restricted networks, prior-authorization delays, and occasional plan terminations can disrupt continuity of care and limit access to preferred physicians or facilities—particularly for patients of independent practices.

 Practicing physicians: Many Advantage plans impose heavier utilization management, lower effective reimbursement after denials, and greater administrative burden than traditional Medicare. This has led some practices and health systems to limit or drop participation, further concentrating care in large systems.

I support beneficiary choice. People should be able to keep Medicare Advantage if it works for them. But choice only works when the underlying system is sustainable and fair to physicians and taxpayers. I will not accept a structure in which overpayments, opaque risk adjustment, and excessive administrative friction undermine traditional Medicare or make independent practice unsustainable.

Policy changes I would support:

a. Accurate payment and risk-adjustment reform: Strengthen coding-intensity adjustments and risk-adjustment methods so payments more closely match true expected costs. Greater transparency into coding practices and encounter data is essential.

b. Consistent prior-authorization and utilization-management standards: Extend TRICARE-modeled rules—standardized forms and clinical criteria, gold carding for high-performing physicians, strict response timelines with automatic approval for non-response, and public reporting of denial and overturn rates—to all Medicare Advantage plans. This protects patients and physicians without eliminating legitimate cost control.

c. Network adequacy, prompt payment, and continuity protections: Require meaningful network standards that do not systematically exclude independent and community providers, enforce timely payment, and ensure smoother transitions (including Medigap guaranteed-issue rights) when plans exit markets.

d. Preserve and strengthen traditional Medicare: Keep traditional Medicare a robust, viable option by reducing its own administrative burdens and preventing the residual risk pool from becoming unsustainable. Site-neutral payments and TRICARE standardization across federal programs would help both traditional Medicare and Advantage environments support independent practices more equitably.

e. Authorize private companies to offer standardized TRICARE For Life-style wraparound products in the commercial market: TRICARE For Life has shown that efficient secondary coverage paired with traditional Medicare can deliver strong out-of-pocket protection with significantly lower administrative burden. I support legislation allowing private insurers to offer a standardized, TRICARE For Life-modeled wraparound product to the broader Medicare population. These products would use proven secondary-payment rules, automatic claims crossover, and limited utilization management. They would compete with both Medigap and Medicare Advantage, expand real choice, and give beneficiaries a simple way to stay in traditional Medicare with solid financial protection—without narrow networks or heavy prior-authorization regimes.

f. Greater transparency and competition: Require clearer disclosure of supplemental-benefit utilization, prior-authorization metrics, and medical-loss ratios. A commercial TRICARE For Life-style option would itself intensify competition on terms that favor patients and independent physicians.

In short, we should protect the choice seniors already have, fix the payment and administrative problems that undermine traditional Medicare and independent practice, and expand efficient secondary coverage options modeled on proven TRICARE designs. That combination strengthens the entire system rather than simply shifting more people into one model.

I welcome further discussion with you and your members and stand ready to be a strong advocate for patients and physicians here in Chester County and beyond.

Thank you again for this opportunity.

Best regards,

Marty Young

Republican Candidate for U.S. Congress Pennsylvania’s 6th District

www.voteyoung.com