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 TrumpSanders urges impeachment trial 'quickly' in the Senate US sending 20,000 troops to Europe for largest exercises since Cold War Barr criticizes FBI, says it's possible agents acted in 'bad faith' in Trump probe 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 AcostaThe 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 Sanders calls Eugene Scalia's Labor Dept. confirmation 'obscene' 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 AlexanderOvernight Health Care — Presented by That's Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Obstacles remain for deal on surprise medical bills Life after Yucca Mountain: The time has come to reset US nuclear waste policy 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 CassidyObstacles remain for deal on surprise medical bills Key House and Senate health leaders reach deal to stop surprise medical bills GOP senators unveil bill to expand 'opportunity zone' reporting requirements MORE (R-La.), who is leading the bipartisan working group with Sen. Maggie HassanMargaret (Maggie) HassanObstacles remain for deal on surprise medical bills Key House and Senate health leaders reach deal to stop surprise medical bills Senators sound alarm on dangers of ransomware attacks after briefing 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.