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Blog | Consumerism

Analysis: Prospects dim for surprise bill legislation

Blog | Consumerism

Analysis: Prospects dim for surprise bill legislation

  • A bipartisan push for legislation to protect patients from massive surprise medical bills is facing significant opposition from doctors and hospitals, according to a report by The Hill.
  • KFF poll: 8 in 10 Americans support legislation to stop surprise medical bills.

The Hill is reporting, “A bipartisan push for legislation to protect patients from massive surprise medical bills is facing a buzzsaw of opposition from doctors and hospitals and reservations from some Democrats worried about delivering President Trump a health care victory when he is still attacking ObamaCare. The surprise billing measure has support from bipartisan committee leaders in both the House and Senate, patient advocates and insurers — and was moving forward quickly before Congress left town for August. It was seen as one of the most promising avenues for lawmakers to target health costs this year. But those efforts are stalling amid a fierce lobbying blitz and political pressures as the 2020 elections nears.

There are still powerful committee chairmen backing the effort, which would protect patients from getting massive bills when they go to the emergency room and only later discover that one of the doctors who cared for them was not in their insurance network. Adding to the delays three different committees in the lower chamber are jockeying with each other to be the one to address the issue. In addition to the legislation already passed out of the House Energy and Commerce Committee, the House Ways and Means Committee and the House Education and Labor Committee are both working on their own legislation.  Sources say they expect the Ways and Means legislation in particular will be more friendly to doctors and hospitals than the Energy and Commerce legislation is.” 


I initially anticipated some type of legislation protecting patients from surprise bills would pass this year. This is an issue that conceptually has strong bi-partisan support and could provide a “win” related to “doing something” to reduce healthcare costs.

KFF poll: 8 in 10 Americans for legislation to stop surprise medical bills

There are solutions from states like New York that provide a framework for legislation. The conceptual gap between competing solutions isn’t unbridgeable. And oh yeah . . . and the public wants to see Congress do something about this. A recent Kaiser Family Foundation poll finds, “Nearly 8 in 10 Americans support legislation to protect people from surprise medical bills. That support persisted no matter which party was asked: 84% of Democrats, 78% of independents and 71% of Republicans said they support surprise billing legislation, according to the poll.”

Prospects for bill passage pretty dim

And while a bill may still pass, I think the prospects are much, much dimmer as detailed by The Hill article. If something relatively broad does move, my guess is it looks like the Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019 (STOP Act of 2019) from Senators Maggie Hassan (D-Mass.) and Bill Cassidy (R-La.). It couples a geographic median payment approach with an arbitration option to alleviate concerns about increasing health plans’ leverage in contract negotiations with providers. 

About the Author

Chad Mulvany, FHFMA,

is director, healthcare finance policy, strategy and development, HFMA’s Washington, D.C., office.


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