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Ending Surprise Medical Billing

Heart wrenching stories of American workers and families who have been devastated by surprise medical bills are far too common throughout our country. This harmful and increasing practice leaves patients with uncertainty and apprehension about how to meet their health care expenses. It’s understandable that surprise medical bills are the leading health care concern for Americans, surpassing worries about high premiums, high deductibles, and rising drug costs. The good news? There is bipartisan agreement in Congress that immediate action must be taken to shield Americans from the crippling financial horrors that surprise medical bills present.

Yesterday, the House Education and Labor Committee took a significant step towards delivering transparency and certainty for consumers when it comes to surprise medical bills by marking up and advancing H.R. 5800, the Ban Surprise Billing Act. H.R. 5800:

  • Protects patients from receiving surprise bills by limiting cost sharing to their plans’ in-network rates and prohibiting out-of-network providers from sending balance bills that exceed the in-network rate;
  • Protects air ambulance patients and takes steps to address ground ambulance surprise bills;
  • Requires health plans to maintain up-to-date and accurate provider directories;
  • Improves consumer access to information regarding expected cost sharing; and
  • Improves transparency regarding in-network and out-of-network deductibles and out-of-pocket limitations.

As Congress continues to consider several comprehensive proposals from different House and Senate committees to combat this issue, it is important to note that we must implement solutions that put patients FIRST.

The Trump administration has expressed apprehensions about some legislation, stating it is “concerned that a push to overuse arbitration will raise healthcare costs.”

The Trump Administration is right to have concerns about an arbitration-focused approach. In fact, we’ve already seen instances of arbitration contributing to rising health care costs. NPR reports that “according to an analysis of newly released data from New York's Department of Financial Services, the New York model is making health care substantially more expensive in the state. In fact, arbiters are typically deciding on dollar amounts above the 80th percentile of typical costs.”

Under no circumstances should Congress implement a federal solution to surprise medical billing that will contribute to our nation’s already rising health care costs. Solving one problem and simultaneously intensifying another is not an appropriate way of governing.

In his State of the Union Address, President Trump said, “The American patient should never be blindsided by medical bills.” We agree.

Workers and families deserve certainty about their health care coverage, and the bipartisan Ban Surprise Billing Act passed by the Education and Labor Committee is a step in the right direction to shielding American families from financially devastating surprise medical bills.