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Trump pushes to end surprise medical billing for hospital care

President Trump on May 9 called on Congress to pass legislation protecting consumers from “surprise medical bills.” (Video: The Washington Post)
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President Trump on Thursday called on Congress to help protect American consumers from unexpectedly large medical bills after they go to the hospital.

The president said that Democrats and Republicans alike should work quickly to stop “surprise” billing in the health-care industry. The unexpected bills are often high charges from doctors or facilities that are outside an insurer’s network, often unbeknown to patients. Trump said these practices are bankrupting patients through “health-care costs that are absolutely out of control. No family should be blindsided by outrageous medical bills.”

In his remarks in the Roosevelt Room at the White House, Trump sought to align himself with aggrieved consumers as health-care costs emerge as a dominant theme in the 2020 presidential election. His remarks also struck a bipartisan tone as he wars with House Democrats about oversight investigations and policy disagreements.

The presidential nudge could inject momentum into an issue on which there is broad consensus on Capitol Hill about a need for federal action — but fervent disagreements within the health-care industry over the details.

Trump did not delve into many specifics but outlined contours of potential legislation where there tends to be agreement. He said patients who are taken to emergency rooms should not be charged extra if the hospitals or the ER doctors are outside the patients’ insurance networks. Patients similarly should not be sent unexpectedly large bills if the hospitals and main physicians they choose for elective surgery are covered by their insurers, but an extra doctor — such as an anesthesiologist or radiologist — is not, he said.

Trump’s tone was uncommonly collaborative and bipartisan. “My administration is eager to work with both parties” to tame medical bills, Trump said. “From what I understand, we have bipartisan support, which is kind of shocking.”

“People are getting hammered right now,” he said, urging Congress to adopt “one honest and fair transparent bill and stop the erosion of the public trust we are seeing.”

Public opinion surveys show broad concern about surprise medical bills — and a belief that the government should do something about them. A poll last month by the Kaiser Family Foundation found that 50 percent of the respondents said protecting people from such bills should be a top priority for Congress, and 36 percent said it should be an important, though not a top, priority.

That meant that surprise bills ranked just slightly behind lowering prescription drug costs and preserving insurance protections for people with preexisting medical conditions among the health-care issues that respondents wanted Congress to resolve.

Senior administration officials, briefing reporters just before the president spoke, said that the White House also is urging Congress to require hospitals to tell elective-surgery patients in advance whether any of their care is to be provided by practitioners who are outside the patients’ insurance networks and — if so — to require that the patients be given written price estimates and the opportunity to consent.

The White House is not proposing an outright ban on billing patients extra for out-of-network elective care as long as patients are informed up front.

Senior administration officials said the White House does not favor a system of binding arbitration over surprise bills between physicians who provide the care and the insurers as a means of determining the proper payment.

That pleased the health insurance industry, which opposes the idea of binding arbitration, contending that it leads to unnecessarily high payments. “Arbitration gives equal weight to inflated doctors’ bills . . . [and] negotiated rates,” said Adam Beck, vice president for policy of America’s Health Insurance Plans, an industry trade group.

But Vidor Friedman, an Orlando emergency room doctor who is president of the American College of Emergency Physicians, said that in states such as New York, where arbitration has been tried, it is proving helpful in instances in which either doctors or insurers had unreasonably high or low rates.

Still, Beck, Friedman and a major hospital trade group praised the White House for drawing attention to the issue.

“We think that patients should be held harmless for these out-of-network charges to their expected cost-sharing, so the White House’s interest focuses a light on an issue that Congress should address,” said Charles N. “Chip” Kahn III, president of the Federation of American Hospitals.

Trump had broached the issue of “price transparency” in his State of the Union address in early February.

A bipartisan group of senators plans to introduce a bill this month to limit surprise bills, culminating nearly a year of legislative work on the issue. Two leaders of the group, Sens. Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.), were among the senatorsattending the White House event.

Hassan last fall introduced a separate bill on the issue that would have included arbitration. Speaking to reporters after the White House event, Cassidy and Hassan indicated that they still favor such a process.

The top Democrat and Republican on the House Energy and Commerce Committee said they also are developing bipartisan legislation to address the issue of surprise medical bills. “No family should be left in financial ruin through no fault of their own,” Energy and Commerce Chairman Frank Pallone Jr. (D-N.J.) and the ranking Republican member, Greg Walden (Ore.), said in a joint statement.