Congressional Action on “Surprise Bills” Continues

July 2, 2019

Addressing surprise medical bills has been a top health care priority for the 116th Congress, with both parties and chambers devoting considerable time to proposals. GNYHA strongly agrees with the need to protect American families from surprise medical bills. Any surprise billing legislation that is enacted into law will be extremely consequential for GNYHA members, and we have been extremely active on Capitol Hill to educate lawmakers and their staff on what such a bill should and should not do.

The Senate Health, Education, Labor and Pensions (HELP) Committee is a key committee addressing surprise bills. Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) worked on the Lower Health Care Costs Act (S. 1895), a bipartisan proposal to address health care costs that included a comprehensive plan for surprise bills. Unfortunately, the final proposal would significantly hamper hospitals’ ability to contract with insurers by pegging out-of-network payments to the insurer’s median contracted rate. This will drive in-network rates downward, hurting hospitals and benefiting insurers, and we strongly object. Unfortunately, the committee approved the legislation last week by a 20-3 vote despite aggressive opposition by GNYHA (including a comprehensive comment letter) and other hospital groups.

The Senate’s surprise billing debate is far from over. Other Senators have released proposals, such as the bipartisan STOP Surprise Medical Bills Act that Senator Bill Cassidy (R-LA) is leading—more information on this proposal can be found here—and the Senate Finance Committee could release its own proposal. GNYHA has been in close contact with Senate Minority Leader Chuck Schumer’s (D-NY) office, which knows of our significant objections to the HELP proposal.

On the House side, the Energy & Commerce Committee’s bipartisan No Surprises Act proposal remains the most notable effort. GNYHA’s comment letter on this proposal can be found here. Similar to the Senate HELP proposal, this legislation gives insurers unfair leverage in contract negotiations with hospitals. We have communicated our concerns to committee members, including Committee Chairman Frank Pallone (D-NJ). It is unclear how the committee will act on this legislation in the immediate future.

A bipartisan working group of House members led by Representatives Raul Ruiz, MD, (D-CA) and Phil Roe, MD, (R-TN) has released their own proposal, the Protecting People from Surprise Medical Bills Act. Local Representative Joe Morelle (D-NY) is a member of the working group. While the bill has been characterized as modeled on New York’ successful surprise billing law, it does not include the same protections for hospitals. GNYHA is working with the American Hospital Association (AHA) and House staff on possible revisions.

GNYHA understands the need to address surprise medical bills and protect patients, and we have released a set of principles outlining what surprise billing legislation should look like. Feel free to use the principles and our comment letters in your advocacy efforts.

We will remain extremely active on this issue and keep you informed of any relevant developments.