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 PalloneBipartisan House lawmakers announce compromise anti-robocall bill Key senators release bipartisan package to lower health care costs Top Trump health official warned against controversial ObamaCare changes in private memo MORE (D-N.J.) and ranking member Greg WaldenGregory (Greg) Paul WaldenHillicon Valley: House lawmakers reach deal on robocall bill | Laid-off journalists launch ads targeting tech giants | Apple seeks tariff exemptions | Facebook's Libra invites scrutiny Bipartisan House lawmakers announce compromise anti-robocall bill Key senators release bipartisan package to lower health care costs MORE (R-Ore.) comes after President TrumpDonald John TrumpFormer Joint Chiefs chairman: 'The last thing in the world we need right now is a war with Iran' Pence: 'We're not convinced' downing of drone was 'authorized at the highest levels' Trump: Bolton would take on the whole world at one time 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 CassidyOvernight Health Care: Key Trump drug pricing proposal takes step forward | Missouri Planned Parenthood clinic loses bid for license | 2020 Democrats to take part in Saturday forum on abortion rights The Hill's 12:30 Report — Presented by MAPRx — Trump calls off Iran strike at last minute The Hill's Morning Report — US strikes approved against Iran pulled back MORE (R-La.), Maggie HassanMargaret (Maggie) HassanSecond ex-Senate staffer charged in aiding doxxing of GOP senators Key endorsements: A who's who in early states Overnight Health Care: Poll finds most Americans misunderstand scope of 'Medicare for All' | Planned Parenthood chief readies for 2020 | Drugmakers' lawsuit ramps up fight with Trump MORE (D-N.H.) and Michael BennetMichael Farrand Bennet Hickenlooper, Bennet bring deep ties to 2020 debate stage Democrats talk up tax credits to counter Trump law Overnight Health Care: Key Trump drug pricing proposal takes step forward | Missouri Planned Parenthood clinic loses bid for license | 2020 Democrats to take part in Saturday forum on abortion rights 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.