Texas has a way to help patients appeal their surprise medical bills. It's not open to everyone. But it's still overwhelmed and unable to keep up with demand.

How it works: Texas operates a mediation program for patients hit with a surprise out-of-network bill, and it has expanded access to the program twice over the past 4 years.

  • The Texas Tribune lays out the details: Once patients file their bill with the state board, any bill collections are paused and insurers and providers have 30 days to work something out.
  • Most cases are resolved there. The others are referred to a formal mediation process.

By the numbers: Demand for the program skyrocketed last year, per the Tribune.

  • Texas received just 43 mediation requests in 2013. Last year, it received more than 4,500 complaints, totaling almost $9 million in hospital charges. Officials are expecting more than 8,000 new requests this year.

That's more than the commission can keep up with, and it's been trying to grow while still managing a workload that's very time sensitive for patients.

  • "It's somewhat like trying to rebuild the firehouse while you're answering calls to put out fires," Texas insurance commissioner Kent Sullivan said.

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

Go deeper

Updated 7 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 4:30 p.m. ET: 30,306,469 — Total deaths: 948,147— Total recoveries: 20,626,515Map.
  2. U.S.: Total confirmed cases as of 4:30 p.m. ET: 6,705,114 — Total deaths: 198,197 — Total recoveries: 2,540,334 — Total tests: 92,163,649Map.
  3. Politics: In reversal, CDC again recommends coronavirus testing for asymptomatic people.
  4. Health: Massive USPS face mask operation called off The risks of moving too fast on a vaccine.
  5. Business: Unemployment drop-off reverses course 1 million mortgage-holders fall through safety netHow the pandemic has deepened Boeing's 737 MAX crunch.
  6. Education: At least 42% of school employees are vulnerable.

Court battles shift mail-in voting deadlines in battleground states

Illustration: Sarah Grillo/Axios

Michigan joins Pennsylvania in extending mail-in ballot deadlines by several days after the election, due to the coronavirus pandemic and expected delays in U.S. Postal Service.

The latest: Michigan Court of Claims Judge Cynthia Stephens ruled that all ballots postmarked before Nov. 2 must be counted, so long as they arrive in the mail before election results are certified. Michigan will certify its general election results on Nov. 23.

Ina Fried, author of Login
37 mins ago - Technology

Interview: Unity CEO explains his company's unusual IPO

CEO John Riccitiello virtually ringing the NYSE bell as Unity shares began trading on Friday. PhotoL Unity

Unity Technologies was just one of many companies with blockbuster IPOs this week, but it took a decidedly different approach, using data rather than handshakes to decide who got to invest and at what price. CEO John Riccitiello explained why in an interview with Axios.

Why it matters: Traditionally, bankers and companies set IPO prices based on conversations and expectations, a process that has been criticized as basically leaving money on the table.