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H.R. 3502: Protecting People From Surprise Medical Bills Act


Half the states now have laws against surprise medical bills, so should the federal government too?

Context

Surprise medical bills, stemming from disputes between insurance companies and healthcare providers, are often passed along to the patient at life-ruining costs. For example, the Texas high school teacher charged $108 thousand for his heart attack. Or the former cocktail waitress in Washington charged $227 thousand for her heart attack.

States from across the political spectrum have passed laws cracking down on the practice. In 2019 so far, those states have included Colorado, New Mexico, and Texas. Other states from across the political spectrum — including Arizona, Maine, Minnesota, and Oregon — passed such laws in 2017 and 2018.

As of January, according to a Commonwealth Fund analysis, 25 states offered no such protections. While the other 25 states did, only nine met the Commonwealth Fund’s definition of “comprehensive” protections. There is no such federal regulation.

What the bill does

The Protecting People From Surprise Medical Bills Act would ban the practice of unexpected healthcare expenses by instituting a process called IDR, or independent dispute resolution.

Under this process, both the insurer and the healthcare provider name their cost for the patient’s care or procedure, then a neutral arbiter chooses what they believe is the fairer price. The practice has been instituted in several states recently, including New York and Washington.

It was introduced in the House on June 26 as bill number H.R. 3502, by Rep. Raul Ruiz (D-CA36).

What supporters say

Supporters argue the legislation prevents a practice that can leave middle-class and lower-class Americans financially devastated, through no fault of their own.

“For too many middle-class families, receiving an unexpected and very expensive bill from an out-of-network provider is devastating and can lead to severe anxiety, depression, and financial ruin,” Rep. Ruiz said in a press release. “This must end.”

“[This] legislation… will ban these bills and keep families out of the middle by using a fair, evidence-based, independent, and neutral arbitration system to resolve payment disputes between insurers and providers,” Rep. Ruiz continued. “As an emergency doctor, patients come first and must be protected.”

GovTrack Insider was unable to locate any explicit statements of opposition.

Odds of passage

The bill has attracted 78 bipartisan House cosponsors: 43 Republicans and 35 Democrats. It awaits a potential vote in either the House Energy and Commerce, Oversight and Reform, or Ways and Means Committee.

Identically-titled but textually different legislation, at only nine pages instead of 32, was also introduced in the House by Rep. Ross Spano (R-FL15) and in the Senate by Sen. Rick Scott (R-FL). However, neither version has attracted a single cosponsor.

A similarly-themed Senate bill called the STOP Surprise Medical Bills Act [S. 1531] has also been introduced by Sen. Bill Cassidy (R-LA). It’s attracted 26 bipartisan Senate cosponsors: 14 Democrats and 12 Republicans.

Whichever version of the legislation passes Congress — assuming one of them does — President Trump has indicated he’ll sign it into law.

“They weren’t told by the doctor. They weren’t told by the hospitals in the areas they were going to. And they get, what we call, a ‘surprise bill,’” President Trump said in a May speech at the White House, joined at the podium by a Texas man billed $110 thousand for his heart attack and an Ohio woman charge $17,850 for her urine drug screening.

“Not a pleasant surprise; a very unpleasant surprise. So this must end.”

Last updated Sep 10, 2019. View all GovTrack summaries.

The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Jun 26, 2019.


Protecting People From Surprise Medical Bills Act

This bill makes a series of changes relating to health care costs and billing practices.

Among other things, the bill

applies in-network cost-sharing requirements to certain emergency and related non-emergency services that are provided out-of-network; requires health insurers to include in-network and out-of-network deductibles, as well as out-of-pocket maximum limitations, on enrollee insurance cards; requires health insurers to provide online and print directories of in-network health care providers; and prohibits health care providers from billing individuals for services more than a year after such services are provided.