Opinion

It’s Time to End Surprise Medical Billing

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Posted: Oct 06, 2020 3:19 PM
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It’s Time to End Surprise Medical Billing

Source: AP Photo/Elaine Thompson

As the fall season moves into full swing and temperatures begin to drop, Americans are growing uneasy about the predicted uptick in COVID-19 cases. Coronavirus is likely the most substantial phenomenon of the decade, if not this century, and the impact it has had on America’s health care system will be studied for years to come. One issue in particular that has been near the top of the discussion during the pandemic is surprise medical billing, which has consistently been a sore talking point for many Americans even since long before COVID-19 became a global crisis.

When the pandemic initially became widespread, President Trump and Congress worked to ensure that testing for the virus was made readily available. However, countless stories quickly surfaced about how patients who sought care or testing for COVID-19 received an out-of-pocket medical bill. Reading these headlines was the first time that many Americans had heard of surprise medical billing, though for patients who have found an unexpected bill in the mail, it is an unfortunate situation that they are all too familiar with.

Surprise medical billing is a longstanding problem that has been occurring for far too long. Before COVID-19, patients would frequently receive a surprise medical bill following an unfortunate accident where they were rushed to the nearest hospital by an ambulance. In many cases, particularly in rural areas, the hospital that treated the patient was out of their insurance provider’s network, resulting in an astronomical out-of-pocket expense.

Amanda Bowes, a health policy analyst in Maryland, was among the most recent surprise medical billing victims to make national headlines after she received a COVID-19 test at an urgent care facility. Fortunately for her, after protesting with her insurer, the charge was reversed. But Ms. Bower’s experience seems to be an anomaly. Sadly, far too many Americans continue to receive surprise medical bills every day, and many end up paying for them outright.

After witnessing stories like Ms. Bower’s, President Trump recently signed an executive order directing Health and Human Services Secretary Alex Azar to work with Congress and find a permanent solution for surprise medical bills. Fortunately for Secretary Azar, and for all Americans, Senator Bill Cassidy has already introduced legislation which does just that.

Senator Cassidy’s legislation, called the STOP Surprise Medical Bills Act, uses an arbitration method that is similar to the successful systems used in New York and Florida. Under the proposed bill, patients automatically pay their normal in-network cost-sharing amount should they accidentally receive medical care from an out-of-network provider. The highlight of the bill is that it not only offers patients protection from surprise medical bills, but it also allows for them to be completely removed from any dispute between the hospital and insurance provider. I am confident that congressional leaders such as Senate Majority Leader Mitch McConnell, who has stood alongside Americans when they are most vulnerable, will support the STOP Surprise Medical Bills Act so that patients can be afforded the key safeguards they need. 

Unfortunately, some members of Congress have offered up a worse alternative, called rate-setting, which is a method that voters in key Senate battleground states overwhelmingly oppose according to a new Taxpayers Protection Alliance poll. Of the active voters that participated in the poll, 74 percent agreed that they would rather have an independent third party resolve any payment dispute, much like the system used under the STOP Surprise Medical Bills Act, instead of the federal government becoming involved.

Coronavirus, for now, is here to stay. But surprise medical bills may be on their way out thanks to President Donald Trump and Senator Bill Cassidy. New York and Florida have proven that an arbitration method is a practical and effective solution that protects patients. By passing the STOP Surprise Medical Bills Act, Congress can end surprise medical bills and allow Americans to receive a coronavirus test without having to fear an out-of-pocket charge. 

Jesse Grady attends Maryland Law, is a former Regional Field Director for the Texas GOP, and aformer staff member of President Donald J. Trump’s 2016 campaign

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