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 AlexanderThe Hill's Morning Report - How will Trump be received in Dayton and El Paso? McConnell faces pressure to bring Senate back for gun legislation Criminal justice reform should extend to student financial aid MORE (R-Tenn.) and Sen. Patty MurrayPatricia (Patty) Lynn MurrayOvernight Health Care: Planned Parenthood to leave federal family planning program absent court action | Democrats demand Trump withdraw rule on transgender health | Cummings, Sanders investigate three drug companies for 'obstructing' probe Democrats demand Trump officials withdraw rule on transgender health The Hill's Morning Report - Progressives, centrists clash in lively Democratic debate 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 CassidyA cash advance to consider Bottom Line I'm not a Nazi, I'm just a dude: What it's like to be the other Steve King MORE (R-La.), Michael BennetMichael Farrand BennetThe Hill's Campaign Report: Democratic field begins to shrink ahead of critical stretch The Hill's Morning Report - Trump hews to NRA on guns and eyes lower taxes The Hill's Morning Report - Trump searches for backstops amid recession worries MORE (D-Colo.), and Maggie HassanMargaret (Maggie) HassanTrump makes rare trip to Clinton state, hoping to win back New Hampshire Empower the VA with the tools to help our veterans Schumer to Trump: Demand McConnell hold vote on background check bill 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.”