Feb 10, 2020 - Health

Congress remains gridlocked on surprise medical bills

Congress dealing with surprise medical bills
Illustration: Aïda Amer/Axios

Congress says it's trying again to pass legislation protecting patients from surprise medical bills, but it doesn't appear to have resolved any of the fights that derailed the effort late last year.

The big picture: Surprise billing is the unique issue that splits lawmakers not by party, but by which industry group — insurers or providers — they sympathize with more. And both industries are fighting hard for their favored solution.

Driving the news: Two House committees released new surprise billing proposals on Friday, confirming that while everyone wants to prohibit surprise bills, there's still no agreement on how to resolve payment disputes between insurers and providers.

  • The Ways and Means Committee proposal includes a mediation process for when insurers and out-of-network providers can't agree on a payment rate, while the Energy and Commerce Committee's proposal from last year would decide payment rates using a blend of both arbitration and a benchmark.
  • The Education and Labor Committee's proposal — also released Friday — is similar to the Energy and Commerce plan.

What they're saying: The industry responded predictably to Friday's news.

  • The Coalition Against Surprise Medical Billing, a group representing employers, insurers and unions, blasted the two new proposals, while the Federation of American Hospitals released a statement in support of the Ways and Means plan.
  • The groups' positions on the Energy and Commerce plan are reversed.

The bottom line: Lawmakers are faced with the same hard decisions that they punted in December, and industry groups aren't giving any indication that they'll make things any easier for members.

Go deeper: Surprise medical bills inflate everyone's health insurance premiums

Editor’s note: This piece was corrected to give more details and more accurately characterize the Energy and Commerce Committee's proposal.

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