I would be fine with an opt out.   I would not be fine with both of the provisions you mentioned because combined they are stupid.   But I would be fine with eliminating discharge through bankruptcy of life saving procedures as required by the hospitals to provide through current law.  Then healthcare entities could decide on policies for non lifesaving care to require insurance or payment upfront in addition to the OPTION TO offer credit terms similar to any bank card that 'could' be discharged in bankruptcy and allow those doctors to decide how much risk they wanted to take on collecting their payments.  Most likely doctors would say insurance or upfront payments cash or card and let credit card companies bear the costs of defaults on the debt.