The House Ways and Means Health Subcommittee May 21 convened witnesses from the American Hospital Association (AHA), the American Medical Association (AMA), America’s Health Insurance Plans (AHIP), and the ERISA Industry Committee (ERIC) to discuss how to protect patients from surprise medical bills.
Subcommittee Chair Lloyd Doggett (D-Texas) opened the hearing by highlighting a local San Antonio television series titled, “Show Me Your Bill,” which chronicles patients’ surprise medical bills, allows patients to tell their stories, and helps them get resolution for these bills. Doggett emphasized that surprise medical bills are a nationwide problem, and that there are numerous bipartisan proposals currently in Congress to address the issue. Doggett stated, “I support whichever solution can secure 218 votes here in the House and gain Senate approval and the President’s signature.”
In his opening statement, Subcommittee Ranking Member Devin Nunes (R-Calif.) agreed with Chairman Doggett that surprise medical bills are a nationwide problem, and he also highlighted his home state’s new law which “has pretty robust protections against balance billing patients, going so far as to set a required reimbursement scheme.” Nunes also expressed dismay that the federal government may have to step in, stating that “the organizations represented [on the panel] … have the power, and I would argue the responsibility, to solve this issue for patients. I think there are a lot of different steps you should voluntarily take to protect your patients and policyholders.”
Several of the witnesses expressed concern with the concept of rate setting, including AHA Executive Vice President of Government Relations and Public Policy Tom Nickels and Bobby Mukkamala, MD, a physician from Florida and AMA board member. Nickels said that setting a reimbursement standard in law would create a “disincentive for insurers to maintain adequate provider networks.” He added that including “bundling” of hospital and clinical services into a single bill would add significant complexity to what should be a straightforward solution.
Nickels also expressed support for the ability to arbitrate between providers and insurers, should an agreement on payment rate fail to be reached. Jeannette Thornton, senior vice president for product, employer, and commercial policy at AHIP, disagreed, stating that arbitration could drive up premiums and that “there’s a likelihood that they’re [the arbitrator] going to want to take the providers’ price, as well as you’re really sort of rewarding a provider from coming in with an overall higher price in the first place.”
Most members of the subcommittee agreed that the federal government would likely have to step in with a solution to protect patients from surprise medical bills and emphasized that any solution should be bipartisan in nature.
This hearing occurred as both Congress and the White House have turned their attention to surprise medical bills over the past few weeks, with lawmakers in both chambers releasing proposed legislation and the President releasing overarching principles for Congress to follow as they generate legislative proposals [see Washington Highlights, May 17, May 10].