A legislative package from Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) would handle surprise medical bills by having insurers pay them the “median in-network rate,” meaning the rate would be similar to what the plan charges other doctors in the area for the same procedure.
The Senate Health, Education, Labor and Pensions Committee is scheduled next week to mark up a massive legislative package on curbing health costs, but some of the details remain unresolved, including what formula to use to pay doctors and hospitals involved in surprise medical bills.
A new state law says hospitals and insurers will have to work it out among themselves when they can’t agree on a price — instead of sending huge bills to patients. “Bill of the Month” patient Drew Calver galvanized attention on the issue after he told his story to KHN, NPR and “CBS This Morning.”
Nearly 9 in 10 Democrats or Democratic-leaning independents said it is very important for candidates to discuss health issues. But they are sharply divided among the goals of lowering costs, increasing access, protecting the Affordable Care Act or moving to a “Medicare for All” plan, a poll by the Kaiser Family Foundation reported.
The median cost of an air ambulance bill is more than $36,000 and seldom covered by insurance, sparking many consumer complaints. Yet none of the proposals introduced or circulating in Congress to fix surprise medical bills address these services.
Lawmakers and patients want to eliminate “surprise” out-of-network medical bills. Hospitals, doctors and insurers say they want to eliminate them, too, but their opposition to one another’s proposals could complicate legislative efforts. Stephanie Armour of The Wall Street Journal, Alice Miranda Ollstein of Politico and Kimberly Leonard of the Washington Examiner join KHN’s Julie Rovner to discuss this, plus the latest in news about reproductive health and health care sharing ministries.
Supporters of the rule say it would strengthen health care professionals’ freedom of conscience, but opponents say it “empowers bad actors to be bad actors.”
Newsletter editor Brianna Labuskes wades through hundreds of health care policy stories each week, so you don’t have to.
Under a program enacted in Washington state this spring, workers can get up to $36,500 to help pay for long-term health care and services such as installing grab bars in the shower or respite care for family caregivers.
The problem affects private drug policies and Medicare Advantage plans that provide both medical and drug coverage and substitute for traditional government-run Medicare. It could leave plan members without coverage.
