How should Congress tackle surprise medical bills?

Johnson City Press • Jul 1, 2019 at 11:00 AM

For decades, our representatives in Congress have squabbled and whined as they tried to put Band-Aids over the gaping holes of our nation’s dysfunctional health care system.

When the blue guys tried to rush a kludged solution to skyrocketing costs and lack of access past the post, the red guys got upset and tried to stand in the way. After the red guys regained power, they tried to kick the legs out from under the blue guys’ teetering tower and put their own plan in place, while the blue guys pulled out all the stops to make way for their own sabotage attempts.

As the disheartening drama played out in Washington, D.C., our health care costs continued to rise, and our insurance coverage became more complicated. Many of us are now one medical emergency or devastating diagnosis away from financial ruin.

Recently, the House and Senate have taken a stab at ending the practice of surprise medical billing.

In some cases, like when a patient is treated at an emergency department at a hospital outside their insurance plan’s network of care or when patients receive out-of-network services at in-network hospitals, the care provider sends bills for thousands of dollars to patients seeking the balance of what their insurance did not cover.

A Kaiser Family Foundation survey reported that four in 10 people said they had received an unexpected medical bill in the past 12 months. A costly surprise bill thrown into a family’s already tight budget can disrupt qualities of lives and drive families into financial ruin.

Groups of lawmakers in both chambers agree that something should be done to curb surprise medical billing, although they’ve approached it differently.

In the Senate, a bipartisan group that includes Tennessee’s Lamar Alexander has proposed legislation that would cap how much insurers would have to pay providers based on regional rates of Medicare reimbursements.

Hospital and physicians’ groups oppose setting benchmarks rates on services, saying they would give insurance companies too much leverage and could have unintended consequences on regional health care markets.

In the House, a bill backed by Johnson City physician Rep. Phil Roe, would send disputed medical bills to an arbiter, who would negotiate the final costs for which insurers are responsible.

That proposal has been panned by insurance trade groups as setting up a costly and unnecessary process through which costs are negotiated.

As our representatives hash out a final solution, we wanted to give you a chance to weigh in. How should Congress tackle surprise medical bills? Have you received a surprise bill and want to share your story?

Send your correspondence to [email protected]. Please include your name, telephone number and address for verification. Letters may be no longer than 300 words and will be edited for grammar, style and length.

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