Lawmakers Announce Surprise Medical Billing Deal That Avoids Price Controls

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Posted by Alex Hendrie on Monday, December 14th, 2020, 1:20 PM PERMALINK

Late last week, leaders in Congress announced an agreement on surprise medical billing legislation that avoids relying on government price controls.

While conservatives can debate the extent to which the government should impose rules and regulations on surprise medical billing, lawmakers should be applauded for avoiding price controls in their proposal and should reject efforts to add price controls back into a legislative package.

The bipartisan, bicameral agreement was announced by House Ways and Means Committee Republican Leader Kevin Brady (R-Texas) and Chairman Richard Neal (D-Mass.), House Energy and Commerce Committee Republican Leader Greg Walden (R-Ore.) and Chairman Frank Pallone, Jr. (D-N.J.), House Education and Labor Committee Republican Leader Virginia Foxx (R-NC) and Chairman Bobby Scott (D-Va.), and Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.).

Surprise medical billing occurs when an individual receives an unexpectedly high medical bill as a result of being out-of-network or receiving emergency care. 

Over the past 18 months, some lawmakers have pushed legislation to address this problem by using the heavy hand of government to set rates for any payments made to out-of-network providers. Under this proposal, the government would set a benchmark rate to resolve out-of-network payment disputes between insurers and providers. Benchmark rate-setting would replace private negotiations between insurers and providers with government-set prices, resulting in a blatant price control on the healthcare system. 

The negative impact of price controls would be devastating to healthcare providers. When applied to surprise medical billing, price controls would result in a 20 percent pay cut for doctors, according to the nonpartisan Congressional Budget Office. Over the long-term, price controls could lead to a shortage of doctors and care.

There is strong opposition to price controls in surprise medical billing.

Senator Marsha Blackburn recently released a letter signed by Senator Ron Johnson (R-Wis.), Roger Wicker (R-Miss.), Rand Paul (R-Ky.) and Mike Lee (R-Utah) calling on Congress to reject price controls in an end-of year package.

Senator Kelly Loeffler (R-Ga.) also released a healthcare reform proposal that explicitly rejected price controls.

Earlier this year, Congressman Andy Harris (R-Md.) released a joint letter with almost 40 members of Congress in opposition to price controls in surprise medical billing.

The deal reached by Congressional leaders avoids imposing these government price controls on surprise medical billing. Lawmakers should be applauded for this stance and should reject efforts to add price controls back into a legislative package.

 

Photo Credit: Alex Proimos

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