Trump urges Congress to take action on surprise medical bills

Trump urges Congress to take action on surprise medical bills
© The White House

President TrumpDonald John TrumpHealth insurers Cigna, Humana waive out-of-pocket costs for coronavirus treatment Puerto Rico needs more federal help to combat COVID-19 Fauci says April 30 extension is 'a wise and prudent decision' MORE is pushing Congress to pass legislation that would protect patients from surprise medical bills.

"We're going to hold insurance companies and hospitals totally accountable," Trump said Thursday at an event with congressional lawmakers, Health and Human Services Secretary Alex Azar, Labor Secretary Alex AcostaAlex Alexander AcostaFlorida sheriff ends work release program criticized over Jeffery Epstein The Hill's Morning Report — Presented by National Association of Manufacturers — Whistleblower complaint roils Washington On The Money: Senate confirms Scalia as Labor chief | Bill with B in wall funding advanced over Democrats' objections | Lawyers reach deal to delay enforcement of NY tax return subpoena MORE and patients who have been hit by surprise medical bills.

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"We're determined to end surprise billing for American patients," Trump said. "We want patients to be in charge and in total control"

Administration officials told reporters they are sending a list of principles to Congress that will ultimately form the basis of what they hope will be bipartisan legislation to combat huge, unexpected medical costs. Their top priority is to make sure patients no longer receive separate bills from out-of-network doctors.

During a White House event Thursday, Senate Health Committee Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderSticking points force stimulus package talks to spill into Sunday GOP drafting stimulus package without deal with Democrats Senate coronavirus stimulus talks spill into Saturday MORE (R-Tenn.) told Trump that Congress would bring him a bill in July.

The Health Committee has asked the Congressional Budget Office to analyze a range of potential billing options.

Officials said they want Congress to ban balance billing for out-of-network emergency care. Balance billing happens when out-of-network providers bill patients for the difference between a billed charge and a health plan’s allowed amount.

Officials added that Trump wants patients to have the same out-of-pocket costs regardless of whether the care they receive is in network or not. The overall payments would be determined with negotiations between providers and private insurers. 

“We want to take the surprise out the care people receive when they go to in-network facilities,” a senior administration official said.

In instances of nonemergency, scheduled treatment, the White House wants patients to be informed ahead of time if any of the care will be out of network. They want to require a written estimate upfront of all out-of-pocket costs, along with a single bill from all providers.

A bipartisan group of senators has been working on legislation to stop patients from getting surprise medical bills, which usually occur when a patient gets treatment from an out-of-network doctor, even if they are being treated at an in-network hospital.

The lawmakers have gathered feedback from industry groups and are trying to figure out the details of a revised bill. Legislation to protect patients from surprise medical bills is seen as one of the most likely areas for bipartisan action on health care this year.

Industry groups are jockeying over the legislation to ensure they do not take a huge financial hit, with insurance companies pitted against hospitals and doctors.

White House officials said the involvement of so many special interest groups has impeded the ability of the legislators to work, and members of Congress have been urging Trump to wade into the fight.

Officials said they have ideas they would like lawmakers to consider but want Congress to take the lead. The key question remains how much the insurer has to pay the doctor or hospital and how that amount is determined.

Officials said a host of options are on the table, but essentially ruled out using arbitration, which is the method favored by doctors and has been gaining steam in states.

“We do not have a lot of enthusiasm for arbitration, we think that would be disruptive and would be an unnecessary distraction,” a senior administration official said. “A lot of potential abuses would still be inflicted against patients.”

In a call with reporters following the White House event, Sen. Bill CassidyWilliam (Bill) Morgan CassidyTensions boil over on Senate floor amid coronavirus debate  Overnight Energy: Democratic lawmakers seek emissions reductions in airline bailout | House Dems warn Trump against oil industry bailout | GOP senators ask Saudis to stabilize oil market GOP senators ask Saudis to stabilize oil market MORE (R-La.), who is leading the bipartisan working group with Sen. Maggie HassanMargaret (Maggie) HassanWho should be the Democratic vice presidential candidate? Overnight Health Care: Trump triggers emergency powers in coronavirus fight | McConnell sets first stimulus vote for Sunday | Five sticking points for stimulus talks | Treasury delays tax filing deadline | Dems push insurers to cover virus tests Democrats press insurers to cover all coronavirus testing MORE (D-N.H.), said he isn't concerned that the White House was dismissive of arbitration.

"I don’t think it changes [our approach]," Cassidy said. "I’m not wedded to a particular solution, I'm wedded to the right solution."

Cassidy added that arbitration has a proven track record at the state level, but said he is open to other ideas that have been proven to work.

Updated at 1:48 p.m.