Imagine this: you’re having a medical emergency. You need to get to the nearest hospital—fast. You made it. Doctor says you’ll be fine. That’s the good news. Here’s the bad news: that doctor and that hospital were outside of your insurance’s network of approved hospitals. What does that mean? Well, you’re hit with a surprise medical bill. These are pricey hospital bills you receive—by surprise—for out-of-network care.
You may be wondering how it is just and right-minded to charge quadruple the in-network price for medical services. Well, it isn’t. This is an example of hospitals profiting off emergency situations. They know that patients often don’t have a choice in which hospital they are sent to and don’t have the time to find out if the hospital is within their insurance network. Fortunately, our elected representatives have heard our concerns and have introduced legislation that would bar hospitals from imposing high out-of-network bills on patients.
The Protecting People From Surprise Medical Bills Act, which has over 100 co-sponsors in the House, would ensure that out-of-network patients would not pay more than they normally would for emergency care. Out-of-network patients would only be responsible for the costs outlined in their insurance plans. In short, under this bill, it wouldn’t matter if Americans went to an in-network or out-of-network medical facility.
However, it’s one among many options that Congress is deliberating. Rep. Richard Neal, for example, proposed that the federal bureaucracies and the healthcare industry meet on their own and recommend to Congress federal regulations and pricing benchmarks for medical services. This would empower the industry to set favorable regulations and rates for itself—and would not resolve the issue of expensive out-of-network hospital bills. His proposal protects the interests of the industry, but it does not protect patients.
Some lawmakers are considering placing an incomplete solution inside an end-of-the-year funding bill. This would result in a rushed, watered-down attempt at addressing surprise medical bills. Furthermore, this approach would not resolve the issue because the attempted fix would be scrunched between other laws and regulations—that are unrelated to out-of-network bills—in a broad funding bill. Solving surprise medical bills can’t be done in a few hastily written lines as part of a larger legislative package. It needs its own bill that approaches the issue in its entirety.
And the Protecting People From Surprise Medical Bills Act does exactly that: it addresses every nook and cranny of this complex issue. The bill’s potency and effectiveness in stopping surprise medical bills explains its broad bipartisan support. It has received support from influential members, such as Rep. George Holding. The long-standing patient advocate co-sponsored the bill, which may lead to other leading figures putting their names on it as well. If Representatives Adrian Smith, Ken Buck, Jason Crow, and other well-known names, support this bill, it could give it the momentum it needs to pass through Congress and reach the president’s desk.
The Protecting People From Surprise Medical Bills Act is key to preventing Americans from going into debt to pay for high out-of-network hospital bills. Without surprise medical bills, patients can focus on recovering instead of dealing with another headache.
Buck Newton is a former North Carolina State Senator and Republican nominee for Attorney General.