The House Education and Labor Subcommittee on Health, Employment, Labor, and Pensions April 2 held a hearing titled “Examining Surprising Billing: Protecting Patients from Financial Pain.”
In her opening remarks, Subcommittee Chair Frederica Wilson (D-Tex.) struck a bipartisan tone highlighting that this hearing marked the first Congressional hearing on surprise medical bills, and stating that, “this is an opportunity for us to work together on behalf of our constituents.”
She detailed several stories of patients who had encountered surprise medical bills noting that, “victims of surprise medical billing often have no control over whether their medical provider is in- or out-of-network.”
Rep. Wilson emphasized the importance of taking the patient out of the middle of surprise billing situations by, “either hold[ing] patients harmless against charges or prohibit[ing] the practice of balance billing,” and noted that many states have taken action to protect patients, and that while these “state-level solutions are promising … only Congress can fully close the gaps and loopholes that leave patients vulnerable to severe financial distress.”
In his opening remarks, Subcommittee Ranking Member Tim Walberg (R-Mich.) also agreed that Congress should act stating, “We need solutions that equip patients with the information they need to confidently seek treatment without the worry they’ll face a huge surprise bill.” He also noted that, “fear of an unexpected medical bill can be paralyzing,” and that Americans are forgoing care that they need to prevent the possibility of being, “responsible for a medical expense they can’t afford.”
The panel was largely in agreement that patients should be held harmless from surprise medical bills and questioned the witnesses about how to prevent the situation from the start.
Frederick Isasi, JD, MPH, executive director for Families USA, emphasized the complexity of negotiations between hospitals, physicians, and insurance networks, and noted the need for more clarity on when a hospital or provider is in-network, stating that that, “the patient is not the person who should be responsible for that; it’s the folks who are negotiating.”
Ilyse Schuman, senior vice president of health policy at the American Benefits Council, suggested capping reimbursement for out-of-network emergency services at 125% of what the physician would get from Medicare.
Rep. Phil Roe (R-Tenn.) expressed concerns with this concept, particularly for rural communities, stating that, “we pay our providers less and can keep less than 10% of nurses we train in the area because we can't pay them.”
In addition to Isasi and Schuman, witnesses included Christen Link Young, JD, fellow at the University of Southern California Brooking Schaeffer Initiative on Health Policy; and Professor Jack Hoadley, PhD, Georgetown University, Health Policy Institute, McCourt School of Public Policy.