Feb 10, 2020 - Health

Congress remains gridlocked on 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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Senate Republicans are divided on drug costs and surprise medical bills

Photo: Tom Williams/CQ-Roll Call, Inc via Getty Images

Senate Majority Leader Mitch McConnell told reporters Tuesday that Senate Republicans are divided on bipartisan bills to address both drug costs and surprise bills, The Hill reports.

The big picture: The White House vocally supports the bipartisan drug pricing bill by Sens. Chuck Grassley and Ron Wyden.

White House seems to back insurers in fight over surprise bills

Photo: Brendan Smialowski/AFP via Getty Images

In the debate over surprise medical bills, the White House said today it's "concerned that a push to overuse arbitration will raise healthcare costs" — indicating that it's not on board with the approach doctors and hospitals prefer.

The big picture: Congress is gridlocked between two approaches, pitting insurers against providers. White House spokesman Judd Deere also said the administration believes surprise bills from air ambulances should be addressed in the same legislation.

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

How doctors have shaped the fight around surprise medical bills

Doctors' extensive lobbying on surprise medical bills is partly to blame for Congress' inaction on the issue, reports Kaiser Health News.

Why it matters: "As Congress begins its 2020 legislative session, there is evidence the doctors' message has been received: The bills with the most momentum are making more and more concessions to physicians."

Go deeperArrowFeb 13, 2020 - Health