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 PalloneOvernight Health Care: Insurance lobby chief calls Biden, Sanders health plans 'similarly bad' | Trump officials appeal drug price disclosure ruling | Study finds 1 in 7 people ration diabetes medicine due to cost House Democratic chairman launches probe of e-cigarette makers Lawmakers criticize EPA draft rule for curbing rights to challenge pollution permits MORE (D-N.J.) and ranking member Greg WaldenGregory (Greg) Paul WaldenIs there internet life after thirty? Outdated safe harbor laws have no place in trade agreements Trump officials propose easing privacy rules to improve addiction treatment MORE (R-Ore.) comes after President TrumpDonald John TrumpDavid Axelrod after Ginsburg cancer treatment: Supreme Court vacancy could 'tear this country apart' EU says it will 'respond in kind' if US slaps tariffs on France Ginsburg again leaves Supreme Court with an uncertain future 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 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.), 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.) and 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.) 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.