Surprise Medical Bills Focus of Several Congressional Proposals

Feb 8, 2020

Consumer advocates say they're encouraged by a flurry of congressional legislation to rein in surprise medical bills, including one sponsored by U.S. Representative Richard Neal of Springfield.

Neal's bill — sponsored with Republican Kevin Brady — joins at least three other proposals addressing the same basic issues: protecting consumers from unexpected charges and figuring out what's a fair payment.

Michael Miller, policy director of the Boston nonprofit Community Catalyst, said surprise billing is a rare bipartisan concern.

"The most immediate pain point for people is: 'I went to the doctor. I thought it was covered by my insurance plan. Now I'm getting this gigantic out-of-network bill. That's ridiculous. I want to be protected in that circumstance,'" Miller said. "And I think everyone pretty much agrees — both House and Senate and across committees and across parties — everyone pretty much agrees about that." 

But Miller said the proposals do differ around details, such as out-of-network ambulance costs or what happens when an insurance directory is outdated and a patient accidentally chooses an out-of-network provider. 

Even more complicated is how to resolve payment disputes between hospitals, doctors and insurers, and how to determine a reasonable price for medical visits and procedures.

While all the proposals appear to shield patients from the highest surprise bills, Miller said costs covered by insurers or employers would still affect consumers down the line.

"Consumer protection is the most important piece of this. But if you have excessive charges...that just turns around and comes back into your premiums and raises the cost of health care overall," he said. "So consumers do have some interest in making sure that there's a reasonable approach to resolving these payments."

Miller said he's hopeful there's enough common ground in all the committees to come up with a single piece of legislation in the next few months.