These Groups are Pushing Congress on Surprise Medical Billing

Dozens of employer groups are urging lawmakers to pass the Lower Health Care Cost Act, saying the legislation is needed to help reduce rising medical costs for employees and employers.

In a letter filed to Congress this week, 61 groups–including the American Benefits Council, the ERISA Industry Committee, the National Business Group on Health and the National Alliance of Healthcare Purchaser Coalition–called for legislation that would take aim at surprise medical bills, prescription-drug costs, healthcare transparency and other issues.

“In 2019, Congress has a historic opportunity to lower healthcare costs, improve quality, and ensure fairness, competition and transparency in the healthcare system for all Americans,” they wrote. “This opportunity should not be squandered.”

The Lower Health Care Cost Act essentially caps payments to out-of-network providers in the event of a surprise bill. It also takes on a number of provisions aimed at boosting transparency around provider-payer contracts. Those changes could result in savings of $7.6 billion for the federal government over the next 10 years, according to a recent estimate by the Congressional Budget Office and Joint Committee on Taxation.

The groups called for final legislation to “end the surprise medical billing crisis by enacting a local, market-based benchmark backstop.”

“Rather than a government-mandated binding-arbitration process that is opaque and will allow continued price-gouging of patients, Congress should protect patients from surprise billing in a way that will not increase premiums and total healthcare costs,” they wrote. “And patients should be protected not just once they get to the hospital, but also in the ambulance or air ambulance that takes them there.”

They also call for a reduction in the high costs of prescription drugs and tell Congress to include provisions that increase choice and competition and speed generic and biosimilar products to market. They also tell lawmakers that healthcare legislation should include provisions that require transparency, fairness and competition in the healthcare system, improve health-information technology and fund community health centers and other public programs paired with “reforms to improve prevention and management of chronic illness and obesity, modernize data systems, and improve maternal and perinatal health.”

The call for help comes as employees voice concerns over medical bills they weren’t expecting and as employers grow frustrated over trying to manage rising healthcare costs.

Annual premiums for employer-sponsored family health coverage reached $19,616 in 2018, up 5% from the previous year, according to the Kaiser Family Foundation. Employees, on average, pay $5,547 per year toward the cost of their coverage.

“With significant support on both sides of the aisle, as well as in both chambers of Congress, the time is now to take meaningful steps to reduce healthcare costs,” the groups wrote. “Employers are at the forefront of innovation to improve healthcare quality and decrease costs. Final legislation should include provisions to enhance these efforts.”

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Kathryn Mayer
Kathryn Mayer is HRE’s former benefits editor and chair of the Health & Benefits Leadership Conference. She has covered benefits for the better part of a decade, and her stories have won multiple awards, including a Jesse H. Neal Award and honors from the American Society of Business Publication Editors and the National Federation of Press Women. She holds bachelor’s and master’s degrees from the University of Denver.