Dem House chairman, top Republican release measure to end surprise medical bills

Dem House chairman, top Republican release measure to end surprise medical bills
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The Democratic and Republican leaders of the House Energy and Commerce Committee on Tuesday released a discussion draft of a measure to protect patients from getting massive, unexpected medical bills, a sign of bipartisan momentum on the issue.

The release from Energy and Commerce Chairman Frank Pallone Jr.Frank Joseph PalloneMcConnell, Kaine introduce bill to raise tobacco purchasing age from 18 to 21 The Hill's Morning Report - Presented by Pass USMCA Coalition - Restrictive state abortion laws ignite fiery 2020 debate Work on surprise medical bills goes into overdrive MORE (D-N.J.) and ranking member Greg WaldenGregory (Greg) Paul WaldenHere are the eight Republicans who voted with Democrats on the Equality Act House approves anti-LGBT discrimination Equality Act Overnight Health Care — Presented by Campaign for Accountability — House passes drug pricing bills amid ObamaCare row | Senate Republicans running away from Alabama abortion law | Ocasio-Cortez confronts CEO over K drug price tag MORE (R-Ore.) comes after President TrumpDonald John TrumpTrump rips Dems' demands, impeachment talk: 'Witch Hunt continues!' Nevada Senate passes bill that would give Electoral College votes to winner of national popular vote The Hill's Morning Report - Pelosi remains firm despite new impeachment push MORE called for action on the issue last week.

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“Today we circulated a draft bill for review that we believe strongly protects patients and families from surprise medical bills,” Pallone and Walden said in a joint statement. “We must ensure that patients are not responsible for these outrageous bills, which is why our discussion draft removes patients from the middle.”

The measure protects patients from getting massive bills when they get emergency care from a doctor who is outside of their insurance network, with the idea being that, in an emergency, patients should not be expected to ask doctors giving them care whether they are in-network or not.

The bill then sets up a process for determining how much the insurance company needs to pay the medical providers for the out-of-network care, basing the payment rate on the usual rates in that geographic area.

Determining this payment is one of the most controversial aspects of the legislation, with insurers, doctors and hospitals all jockeying to avoid taking a financial hit.

The American Hospital Association criticized the plan on Tuesday, objecting to its methodology of setting payment rates rather than allowing medical providers and insurers to negotiate.

"We strongly oppose approaches that would impose arbitrary rates on providers," said AHA CEO Rick Pollack. 

Trump vowed to take on industry at an event at the White House last week.

“We're going to hold insurance companies and hospitals totally accountable," he said then.

 

The Senate is also working on bipartisan legislation, with Sens. Bill CassidyWilliam (Bill) Morgan CassidySenate passes bill to undo tax increase on Gold Star military families Overnight Health Care — Presented by Campaign for Accountability — House passes drug pricing bills amid ObamaCare row | Senate Republicans running away from Alabama abortion law | Ocasio-Cortez confronts CEO over K drug price tag Bipartisan senators unveil measure to end surprise medical bills MORE (R-La.), Maggie HassanMargaret (Maggie) HassanOvernight Health Care — Presented by Campaign for Accountability — House passes drug pricing bills amid ObamaCare row | Senate Republicans running away from Alabama abortion law | Ocasio-Cortez confronts CEO over K drug price tag Bipartisan senators unveil measure to end surprise medical bills Work on surprise medical bills goes into overdrive MORE (D-N.H.) and Michael BennetMichael Farrand BennetThe Hill's Morning Report - White House, Congress: Urgency of now around budget Overnight Energy: Warren wants Dems to hold climate-focused debate | Klobuchar joins candidates rejecting fossil fuel money | 2020 contender Bennet offers climate plan CNN announces four more town halls featuring 2020 Dems MORE (D-Colo.) collaborating on a proposal in that chamber, which is expected to be released soon.

Calls for action have been sparked by stories like a teacher in Texas last year who received a $108,951 bill from the hospital after his heart attack, even though he had insurance, because the hospital was not in his insurance network.

Pallone and Walden said they are looking for feedback from stakeholders on their draft.

We look forward to receiving constructive feedback on ways to build upon our proposal, so we can advance a bipartisan solution that protects patients from costly surprise medical bills,” they said.

This story was updated at 4:49 p.m.