Who might guess that doing the right thing – going in to be tested for the novel coronavirus after the onset of flu-like symptoms following a trip to China – could result in a surprise medical bill of more than three thousand dollars. This is exactly what happened to Osmel Martinez Azcue, a Miami resident, as reported by the Miami Herald.  Kaiser Health News – Bill of the Month – reports similar stories of Americans getting hit with outrageous out-of-network bills for services they thought their health plan would pay for.

Poll after poll has shown similar results: surprise medical bills are one of the top health concerns for many individuals and families, and people want their elected officials to take action to protect them from financial ruin. Currently, only 13 states have enacted comprehensive legislation to protect their residents from surprise bills, but only for those enrolled in state-regulated health insurance plans. This means people enrolling in self-funded plans (that are regulated by the federal government) and those who live in states that don’t have any protections continue to face unfair balance bills from out-of-network providers, over which they have no control. The matter could get worse, especially for consumers enrolled in UnitedHealth in Arkansas, Georgia, North Carolina and South Carolina – many specialists like anesthesiologists, neonatologists and obstetricians will be out of their health plan’s network and their states have no (or very limited) surprise billing protections. Therefore, Congress must do the right thing – pass comprehensive legislation to end surprise medical bills this year to ensure that everyone across the country is held harmless.

We are encouraged to see that Congress is working toward a bipartisan solution. Since last December, a number of proposals were introduced or have been under consideration in both the Senate and the House: a compromise between the Senate Committee on Health, Education, Labor and Pension and the House Committee on Energy and Commerce; the Ban Surprise Billing Act (H.R. 5800) from the House Committee on Education and Labor; and the Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) from the House Committee on Ways and Means.

Using our framework on a comprehensive approach to end surprise medical bills to evaluate these three proposals, the comparison chart below shows there is enough common ground to help these committees reach compromise.

<p>It is clear that congress has made progress. Each of these proposals contain elements that aim to shield patients from surprise medical bills. However, the job won’t be finished until these proposals merge together into one single bill that includes both comprehensive consumer protections and a reimbursement approach for out-of-network services that prevents either providers or insurers from taking advantage of monopoly power.</p>
<p>With <a href=more than 10,000 people hit by surprise medical bills every day, an immediate passage of comprehensive legislation is vital. As consumer advocates, we call on Congress to hold consumers harmless above all else and pass legislation this year.