A recent CBS news poll found that 66% of Americans are concerned about keeping the cost of health care down. In fact, 43% of Americans shared that they, or someone in their household, had trouble paying a medical bill in the last few years. As a result, surprise medical billing has been a recent focus of legislative efforts in Congress.
On December 8, 2019, Congressional lawmakers announced that they have reached a bicameral, bipartisan deal on legislation aimed at lowering health care costs and addressing surprise billing. While the details of the “Lower Health Care Costs Act of 2019” are not in print yet, House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ), Ranking Member Greg Walden (R-OR), and Senate Health Committee Chairman Lamar Alexander (R-TN) announced an agreement which would do the following:
- End surprise medical bills and create a new system of dispute resolution for out-of-network costs that includes arbitration
- Provide almost $20 billion of funding to the nation’s 1400 Community Health Centers over five years
- Increase the purchasing age of tobacco to 21
- Lower prescription drug and other medical costs by requiring more transparency and competition
- Improve maternal health outcomes
While there appears to be broad bipartisan support for this legislation, it could still face some hurdles as other lawmakers weigh in. The bill’s supporters hope to get the bill signed into law before the end of the year. They may be helped in their efforts by information released this week by the Kaiser Family Foundation (KFF), showing that people who are in the middle of a “health crisis” are often at high risk for surprise medical bills. KFF’s findings included:
- People having surgery or receiving mental health and substance abuse treatment at an in-network hospital are at especially high risk for surprise billing
- Among people with employer-based insurance, out-of-network charges were 50% higher among heart-attack victims than for other diagnoses
- 21% of women undergoing mastectomies experienced out-of-network provider charges
The devil is often in the details, and it remains to be seen whether Congress can get bipartisan legislation across the finish line. As details emerge, we will share them.
About Amy Donovan
Amy is Keenan's Vice President of Legislative and Regulatory Affairs, authoring the firm's Briefings and position papers on legislation, regulation and litigation that have an impact on the firm and its clients.