Jun 27, 2019

Conservatives unhappy with surprise billing approach

Caitlin Owens, author of Vitals

Sen. Rand Paul. Photo: Tasos Katopodis/Getty Images

Some conservative lawmakers and advocacy groups are lining up against Congress' leading solution to surprise medical bills, saying it's too much government interference.

What they're saying: "If government rate setting is viewed as a 'patient protection' in these circumstances, it will lead to efforts to 'protect' patients through government rate setting in others," the Heritage Foundation's Doug Badger wrote.

The big picture: Surprise medical bills often occur when a patient inadvertently sees a doctor who's not in their insurance network, and that doctor bills the patient for the charges that their insurer won't pay.

  • The leading proposals in the House and Senate ban doctors from charging patients more than an in-network doctor would, and require insurers to pay out-of-network providers the median in-network rate for the service in that geographic area.
  • The Senate health committee passed the bill yesterday.

How it's playing: The conservative advocacy group FreedomWorks announced a $50,000 ad campaign this week against what it referred to as the "hidden Republican efforts to bring us ever closer to socialist-style ‘Medicare for All’ proposals."

  • Sen. Rand Paul even invoked Venezuela.
  • "If you fix the price that ER doctors work at, you will get a shortage... This is what happened to Chavez, it’s what happened to Maduro. I don’t think we’re becoming Venezuela soon, but this is part of what they do down there," he said yesterday.
  • And conservative lawyer Paul Clement recently wrote that the approach could be unconstitutional.

Hospitals are catching on to this argument too. "This bill solves the immediate problem for patients, but the unintended consequences of rate setting will lead to more narrow networks and a precedent of government interference in free market negotiations," Chip Kahn, president and CEO of the Federation of American Hospitals, wrote in a statement.

On the other hand, the Manhattan Institute — another conservative think tank — spearheaded a letter signed by more than 2 dozen conservative health wonks that said providers' favorite approach could establish "an inflationary dynamic that accommodates and encourages the rapid growth of costs."

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