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White House puts off action on surprise medical bills, punts to Congress

The White House is putting off executive action to crack down on surprise medical bills, instead calling on Congress to act on the issue.  

The Trump administration had been working on a potentially far-reaching proposal to protect patients from getting stuck with massive “surprise” medical bills when they get care from a doctor who happened to be outside their insurance network, according to people familiar with the plans. 

But after pushback from health care provider groups, GOP lawmakers, and debate within the administration, the White House is instead issuing a much more limited executive order simply calling on Congress to act on the issue. 

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Reining in surprise medical bills has been a priority for both parties for months, and is seen as a key patient protection.  

The order released Thursday calls on the administration to take executive action if Congress does not act by Jan. 1, but it does not specify what that action would be, Secretary of Health and Human Services Alex Azar said on a press call. 

The announcement comes as part of a speech President TrumpDonald John TrumpIvanka Trump, Jared Kusher's lawyer threatens to sue Lincoln Project over Times Square billboards Facebook, Twitter CEOs to testify before Senate Judiciary Committee on Nov. 17 Sanders hits back at Trump's attack on 'socialized medicine' MORE is making Thursday afternoon in North Carolina, where he is seeking to tout his record on health care, an issue where Republicans are being battered by Democrats, ahead of the election. 

The White House had been considering a surprise billing order that would have been the more substantive part of the announcement, coupled with a largely symbolic order on pre-existing conditions. 

But the surprise billing order is now essentially punting the issue to Congress, where both parties have been calling for action for over a year, but nothing has yet passed. 

The White House declined to comment on changes to the surprise billing order.  

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One of the options that had been considered, sources say, was an executive order to ban health care providers from surprise billing patients as a condition of participating in the Medicare program, a serious enforcement stick.  

Health care providers pushed back on that idea with the administration, according to a lobbyist. 

Some GOP lawmakers, including members of the conservative Republican Study Committee in the House, also pushed back on the surprise billing ideas being discussed by the White House, according to a House GOP aide. Conservative outside groups also contacted the White House to object. 

There was also internal debate on the issue within the administration, according to an administration official.  

The result is a far narrower order that simply calls on Congress to keep working on the issue. Lawmakers have so far been unable to reach agreement, despite support for taking action from both parties, amid a variety of turf battles between committees and lobbying from powerful doctor and hospital groups, including some backed by private equity companies. 

Azar said on the press call Thursday the administration hopes feuding industry groups can work something out with Congress. 

“Those special interest groups need to sort it out,” he said.