Mar 19, 2019

Some insurers want Congress to set rates to combat surprise medical bills

Photo: Shane Novak/Getty Images

A coalition of employers and health insurers wants Congress to step in and set doctors' payment rates, in some cases, as a way to combat surprise medical bills.

What they're saying: In a letter to congressional leaders, the group — which includes America's Health Insurance Plans and the American Benefits Council — said Congress should set reimbursement rates for certain services either based on market rates or as a percentage of what Medicare pays.

  • They also suggested banning providers from sending surprise bills to patients in "cases of emergency, involuntary care, or instances where the patient had no choice in their provider."
  • The threat of high out-of-network rates can also raise in-network rates, causing higher premiums for everyone.

Between the lines: It's not every day that insurers endorse government price-setting, even in narrow circumstances.

  • "Large employers and insurance companies are not generally fans of price regulation, so opening the door to that is a big deal, even considering that it’s someone else’s prices they’re talking about controlling," said the Kaiser Family Foundation's Larry Levitt.

The other side: "Not only is it a dangerous precedent for the government to start setting rates in the private sector, but it could also create unintended consequences for patients by disrupting incentives for health plans to create comprehensive networks," the American Hospital Association and the Federation of American Hospitals said in response.

Go deeper: Why ending surprise medical bills is harder than it looks

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Illustration: Eniola Odetunde/Axios

The Trump campaign has invested most of its advertising budget to date on Facebook, testing thousands of versions of ads per day to maximize its spending.

But behind the scenes, a source familiar with the campaign tells Axios, the thinking has shifted: "As everyone can see, we still have strong spending on Facebook, but the percentage of our total media budget [on Facebook] is shrinking."

Trump's revenge tour has the House in its sights

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But after the GOP reckoning in 2018, and experiencing firsthand how damaging a Democratic-led House has been to him, Trump is now personally invested in helping Republicans regain the majority in November, several people familiar with his thinking tell Axios.

Pelosi warns U.S. allies against working with China's Huawei

Nancy Pelosi, Feb. 16. Photo: Sven Hoppe/picture alliance via Getty Images

House Speaker Nancy Pelosi on Sunday cautioned U.S. allies against allowing Chinese telecommunications giant Huawei to develop their 5G networks, arguing at the Munich Security Conference that doing so is akin to “choosing autocracy over democracy," CNBC reports.

Why it matters: Pelosi's hawkish stance marks a rare area of agreement with the Trump administration, which believes Huawei is a national security threat because the Chinese government may be capable of accessing its equipment for espionage.

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