Our Campaign is Changing the Conversation about Surprise Medical Bills

Danielle Blustein
Advocacy Intern

Monday, July 4th, 2016

The American Health Care Journal (AHCJ) recently highlighted that the conversation surrounding surprise medical bills is changing. Fighting surprise medical bills has always seemed like a losing battle for consumers due to the power and money of the medical industry. But now, thanks to the two thousand plus consumers like you who have shared their stories with us, consumers have a new tool to fight surprise bills: state law. Even better: We’re winning in several states!

The AHCJ pointed out that over the past year, an increasing number of states have proposed and passed legislation protecting consumers from surprise medical bills. Before this, consumers were left helpless as doctors and insurance companies argued about the cost of medical procedures, leaving consumers to pay the difference. Now, states are taking a more active role to assist consumers by enacting legislation, often with our support. According to the AHJC, Consumers Union’s focus on passing legislation to end surprise medical bills comes because “they believe it would close a costly loophole in the health insurance system.”

Costly indeed! Our own survey found that nearly one third of Americans with private insurance have received a surprise medical bill in the past two years. Out-of-network surprise bills can run 10 to almost 100 times more than Medicare’s rates, costing consumers hundreds to thousands of dollars. Thankfully, nearly  half of the states in the country are working to pass – or already have in place – consumer protection legislation against surprise medical bills. But the fight isn’t over yet.

While we are winning the battle in the states, there is still more to be done. The End Surprise Billing Act of 2015 H.R. 3770 is a federal bill that was introduced by Congressman Lloyd Doggett of Texas. This bill would make sure that hospitals across the country give consumers advanced notice before being treated by someone not on their insurance plan – and would require patients to agree. If advance notice isn’t possible — like in emergency situations – consumers then would still pay only what they would have paid for the same covered benefits received from a health professional on their insurance. The bill, unfortunately, has been gathering dust since last October when Congressman Doggett introduced the bill to the House Ways and Means Committee.

Consumers Union is a leader in the fight to enact state legislation to protect consumers from surprise medical bills – we’re currently making big strides in states like California and New Jersey thanks to your collective action. As we  look towards the future of surprise medical bills, we’re hopeful that the conversation will shift to national reforms so that consumers across the map are more fully protected.  Click here to join our growing End Surprise Medical Bills campaign  and check out our interactive map to find out  what your state is doing to protect you from surprise medical bills.

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One response to “Our Campaign is Changing the Conversation about Surprise Medical Bills”

  1. Laura Landry says:

    The thing that is difficult to believe is that all of this confusion is not caused by complexity — many industries deal with excessive complexity and still manage to be able to tell whether someone is actually a vendor for a product at the time of purchase.

    I have been working for the last 3 years on dealing with the underlying problem. Their business systems are really powerful, but those IT solutions never, ever contemplated the need to connect the benefit plans directly to the provider network that serves precisely that one benefit plan group and connects to that provider’s contracted rates.

    While this is not simple, it is doable but tedious — it’s not technically difficult.

    And, by the way, keeping out of network doctors from billing their outrageous rates won’t actually solve the problem — the solution is being able to go to places that are in-network in the first place.

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