Opinion

Congress Must Confront Its Own Inaction on Surprise Medical Bills

By Annette Guarisco Fildes & D. Taylor
June 4, 2020 at 5:00 am ET

Amid a historic health care and financial crisis, congressional leaders have passed sweeping reforms to address the fall-out from COVID-19. Yet, despite several relief packages, millions of Americans still face the prospect of a bankrupting surprise medical bill as the pandemic continues. With more than 40 million filing for unemployment and millions more also losing insurance, the delay in passing comprehensive surprise billing protections undermines the health and financial security that American families need at this very moment.

Even before the pandemic, two-thirds of Americans were worried about being able to afford an unexpected medical bill, according to Kaiser Family Foundation. Researchers estimate that the average cost of in-patient treatment for a someone who tests positive for coronavirus will exceed $20,000.

An absolute worst-case scenario for anyone in this midst of this public health and financial crisis would be a surprise medical charge that would put their personal finances into a tailspin. Even in instances where a patient may do everything right – checking to make sure he or she visits an in-network provider, receiving a COVID-19 test from an in-network lab – the prevailing fear of receiving an unexpected, unaffordable surprise bill discourages many from seeking care that might prevent the spread of coronavirus.

We recognize that Congress and the Trump administration have taken some short-term precautions to hold private equity firms, physicians and hospitals accountable for unfair and predatory billing. But the reality is that the health care system – including providers who generate devastating surprise bills – continues to receive billions in taxpayer funding at the expense of American workers who are now even more exposed to these unexpected costs. Surprise medical bills – often with costs that can exceed 2,000 percent of what Medicare pays for the same service – add insult to injury when millions without jobs are now living off their retirement or an unemployment check.

It will take more than a temporary surprise bill ban on hospitals that accept bailout funds to safeguard patients and their families from the surprise billing crisis. It’s incumbent on every senator and representative to put his or her words into action and pass a federal surprise billing ban that will truly safeguard patients from surprise medical bills. Federal legislation that establishes fair, market-based rates for out-of-network charges is the best way to fix the loopholes that allow out-of-network providers to circumvent private-sector negotiations and exploit patients at their most vulnerable.

Washington has had more than enough time to act. After many months of debate and deliberation, leaders from the Senate HELP and House Energy & Commerce committees came to a commonsense, bipartisan proposal in December 2019 that would protect Americans from unexpected, unfair charges when visiting an emergency room or in cases where a patient had no choice in his or her provider. Facing a direct challenge to a highly profitable business model, private equity firms poured millions into a dark money campaign targeted to stop any form of patient protections from moving forward. They continue to push millions of dollars into this misleading and disingenuous advertising even now at the expense of benefits and pay for health workers serving on the front lines of this crisis.

Now that the pandemic is wreaking havoc in lost lives, sick workers and disappearing health insurance, there is no excuse for Congress to wait a day longer. What should have been passed with ease in December of 2019 must be done now in the best interests of patients in the midst of a pandemic. Prohibiting surprise medical billing is critical in our fight against COVID-19 and every other public health crisis in the future. Passing this critical piece of legislation represents a promise made and kept to every American worker, patient and family who is depending on us to do what is right.

Annette Guarisco Fildes is the president and CEO of the ERISA Industry Committee, and D. Taylor is the president of UNITE HERE.

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