Surprise Medical Bills Receive Bipartisan Scorn

Democrats and Republicans were in rare agreement during an April 2 House subcommittee hearing on the issue of surprise medical bills that result when patients go to hospitals that are outside their insurance network: The bills have got to go.

More than half of states provide consumer protection from unexpected out-of-network charges, but most of the laws aren’t comprehensive. The result is a bipartisan public policy problem in need of a federal solution.

The House subcommittee discussed possible legislative solutions, such as placing caps on how much out-of-network providers can charge, relying on doctors and insurers to determine payments within set parameters, and bundling bills for emergency room patients who are treated by out-of-network providers. With bundling, patients would receive a single in-network bill, then hospitals would negotiate with specialists to determine how much they are paid.

Industry representatives from hospitals and insurance companies are pushing back on specific proposals, but there is widespread agreement that any solution must protect patients and keep them out of billing negotiations.

“It’s a consumer-protection issue,” Loren Adler, associate director of the Brookings Institution’s Center for Health Policy, told The New York Times. But it’s also a pretty clear flaw in how markets have developed for physician services. It’s left a loophole that’s being exploited.”

President Donald Trump has also called the issue a priority, and legislation is expected to pass sometime this year.

Sources: The Wall Street Journal, April 2, 2019; NPR, April 2, 2019.