Trump, legislative pressure mounts to ban ‘surprise’ medical bills

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Congress should pass legislation to stop Americans from getting surprise medical bills, President Donald Trump said Thursday, adding momentum to a bipartisan issue.

More than half of Americans say they’ve received a surprise bill after getting care, according to one survey. Sometimes called balance bills, they arrive when a doctor, lab-testing service or hospital charges more than a health insurer is willing to pay. For patients, it can mean adding unexpected financial hassle to an already distressing medical problem.

“No one in America should be bankrupted unexpectedly by healthcare costs that are absolutely out of control,” Trump said at the White House while standing alongside lawmakers, doctors and patients who have received unexpected medical bills. “No family should be blindsided by outrageous medical bills.”

Sen. Lamar Alexander (R-Tenn.), who chairs the Senate’s Health, Education, Labor and Pensions Committee, told Trump during the news conference that he expects to send the president a bill in July.

Among the principles the White House supports: Patients shouldn’t receive separate bills for out-of-network charges they didn’t agree to; emergency care shouldn’t result in surprise bills from out-of-network providers, and patients should get an up-front estimate of costs before they get scheduled care.

Trump said the administration is working on a wider healthcare transparency effort it will talk about in coming weeks.

The Trump administration wants Congress to work out the details on the surprise billing effort and Trump didn’t specifically endorse any existing legislation. A bipartisan group of senators, including Alexander, Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.), has been working on the issue.

Surprise bills are a function of how health insurers set up their networks of covered doctors, hospitals and other providers. When medical providers are in insurers’ networks, they generally can’t bill patients for more than a contractually agreed amount. But when clinicians are out of network, as can happen in emergency situations, patients can be left with staggering charges.

The White House also said that disputes between insurers and providers should be resolved through negotiation and that any solution shouldn’t increase federal spending, Joe Grogan, director of the administration’s domestic policy council, said on a call with reporters before Trump spoke.

“The data would seem to indicate that there are a small number of facilities taking advantage of this situation, and taking advantage of patients, and not protecting the economic wellbeing of their patients,” Grogan said. He said 15 percent of hospitals have more than 80 percent of the emergency visits that result in surprise bills.

More than half of Americans have received an unexpected medical bill, according to a survey last year by the research group NORC at the University of Chicago. One-fifth of emergency-room admissions triggered a surprise bill, according to a 2017 analysis from economists at the Federal Trade Commission.

Action on surprise medical bills has been mentioned as one of the rare places where Democrats and Republicans can find common ground in Washington. Much of the healthcare industry agrees in principle that patients shouldn’t have to deal with the disputes between health insurers and medical providers that lead to the bills. But how the details are worked out has huge stakes for the companies involved.

About half the states have some law to limit consumers’ exposure to balance-billing, and nine of those are considered comprehensive protections, according to a Commonwealth Fund report.

Bloomberg News