Jurisdictional issues scuttled surprise billing fix

Jurisdictional infighting and intense lobbying from industry ultimately scuttled Congress' efforts to deal with surprise medical bills this year.

Why it matters: Surprise bills were about as close to a slam-dunk as Congress gets in health policy, and lawmakers' failure to get such an easy thing across the finish line doesn't bode well for other, harder priorities.

What happened: Key lawmakers — Sen. Lamar Alexander and Reps. Frank Pallone and Greg Walden, who lead the Energy and Commerce Committee — announced a deal on the issue earlier this month.

• Senate Minority Leader Chuck Schumer was concerned about the impact on New York hospitals, but he told other congressional leaders that he wouldn't oppose the deal's inclusion in the year-end spending bill.

After that deal was announced, House Ways and Means Chairman Richard Neal announced a separate agreement with Ranking Member Kevin Brady.

• That put the two committees with jurisdiction over surprise bills on different pages.
• Democratic leaders opted not to pick a side by including surprise bills in a year-end legislative package.

“There’s nothing diabolical about it, or nefarious," Neal told Axios. "We were simply saying, 'time to vet it.' The idea that you were just going to attach this to a spending bill and send it over without that opportunity? I mean, I think that would have been ill-considered.”

What's next: A House leadership aide said they'll try again, with another must-pass bill next spring.

The bottom line: "In an environment where all constituents of all parties are demanding relief from health care cost and complexity, the Democrats should be wary about singing the song of affordability concerns without delivering the goods," said Democratic health consultant Chris Jennings.