Senators ask CBO to review options for preventing surprise medical bills

Senators ask CBO to review options for preventing surprise medical bills
© Greg Nash

The leaders of the Senate Health Committee are asking the Congressional Budget Office (CBO) to analyze possible options for protecting patients from getting hit with massive, unexpected medical bills.

Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderJuan Williams: Republicans flee Trump Romney, Collins, Murkowski only Senate GOP holdouts on Graham's impeachment resolution The Hill's Morning Report — Presented by Better Medicare Alliance — Impeachment angst growing in GOP MORE (R-Tenn.) and Sen. Patty MurrayPatricia (Patty) Lynn MurrayRetirement bill blocked in Senate amid fight over amendments Senate Democrats call on White House to abandon plan to collect DNA from migrants Overnight Health Care: Judge temporarily blocks Alabama near-total abortion ban | Sanders dismisses calls for 'Medicare for All' funding plan | Dems urge Trump not to back down on vaping flavor ban MORE (Wash.), the panel's top Democrat, sent options for analysis to the CBO, according to Senate aides.

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It's the latest sign that lawmakers are serious about moving forward on legislation to address so-called surprise medical bills, a rare issue where there could be bipartisan action this year.  

The goal is to stop instances like a viral story last year of a teacher in Texas who got a $108,951 bill from the hospital after his heart attack because the hospital was not in his insurance network.

Alexander and Murray’s action is preliminary and lawmakers have not decided on the details of any legislation yet.

The two are working in consultation with a bipartisan group of senators that is in discussions on the issue, which includes Sens. Bill CassidyWilliam (Bill) Morgan CassidyUN Security Council to meet after Turkey launches Syria offensive Trump faces growing GOP revolt on Syria To win the federal paid family leave debate, allow states to lead the way MORE (R-La.), Michael BennetMichael Farrand BennetDemocrats debate how to defeat Trump: fight or heal Overnight Energy: EPA watchdog slams agency chief after deputy fails to cooperate in probe | Justices wrestle with reach of Clean Water Act | Bipartisan Senate climate caucus grows Bipartisan Senate climate caucus grows by six members MORE (D-Colo.), and Maggie HassanMargaret (Maggie) HassanHillicon Valley: Facebook launches 'News Tab' | Senate passes bill to take on 'deepfakes' | Schumer outlines vision for electric cars Senate passes legislation to combat 'deepfake' videos Hillicon Valley: Senators seek national security review of TikTok | TikTok denies claims of Chinese government influence | CNN chief rips Facebook policy on political ads | Dem questions DHS' handling of personal data MORE (D-N.H.), a Senate aide said.

Alexander and Murray are known as two of the best bipartisan dealmakers in the Senate. The pair tried, ultimately unsuccessfully, in 2017 and 2018 to pass an agreement to stabilize ObamaCare.

Since then, Alexander has said he wants to move on from debating the politically charged health care law and instead focus more broadly on lowering health care costs, including countering surprise medical bills.

Lawmakers in both parties and industry groups largely agree that patients should be protected from getting massive, unexpected medical bills.

The debate is over how to determine how much the insurer will pay to the doctor or hospital.

Insurers, doctors and hospitals are jockeying over those details, fearful of taking a financial hit in the legislation.

Alexander and Murray sent a range of possible options on those details to the CBO.

One option is to have an arbitrator determine how much the insurer pays the doctor or hospital. Another option is to set a payment rate based off a percentage of Medicare’s payment rates or something similar. A third option is to require hospitals to send a single bill to the insurer, preventing doctors within the hospital from independently charging the insurer at much higher rates.

Those three options are not the only options that Alexander and Murray sent to the CBO, though.

“People go to the emergency room and they suddenly are surprised a few weeks later with a bill for $3,000 from an out-of-network doctor,” Alexander told reporters in January. “We don’t want that happening, so one way or the other I expect to see that addressed in the next several months.”