US families hit with huge surprise medical bills: What can be done

Crippling charges can hit Americans even if they’re insured. “Nightline” talks to families who have received surprise bills, including a doctor and lawmaker, and explores what’s holding up reform.
7:02 | 01/16/20

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Transcript for US families hit with huge surprise medical bills: What can be done
I owe $71,000? Reporter: $70,000 for emergency surgery after a bike accident. We double-checked our insurance, made sure that we would be okay. Reporter: $50,000 for a 24-hour stay in the NICU. How are we going to pay this bill? Reporter: These ar small example of surprise medical bills patients never saw coming. Growing problem with medical debt impacting thousands. Sticker shock after a trip to the emergency room -- Reporter: While the debate over health care in America has focused on the uninsured, those who have insurance also face a broken system. 1 in 6 insured Americans have been hit with a surprise medical bill. In fact, more than two-thirds of all bankruptcies were tied to medical issues and bills. These are people who are doing everything right. Reporter: Elizabeth Rosenthal is editor-in-chief for Kaiser health news which investigates medical bills. They're insured yet stuck paying bills in the thousands if not tens of thousands and sometimes hundreds of thousands of dollars. Reporter: Not even doctors are immune to surprise medical bills. You do have two chipped teeth. Reporter: Dr. Brad Buckingham. The 35-year-old has his own dental practice in Austin, Texas. Outside the office, he's an avid cyclist. I was riding around 100 to 200 miles aweek for awhile there. Reporter: $Years ago he set out for a bike ride with friends but did not go as planned. I came across train tracks. Since it was misty out, the rails were wet. As I went across my wheels came out from independent me. I knew it was bad. I didn't know what it was. I couldn't make words, just screamed. Reporter: His friends called an ambulance. When paramedics arrived, they discovered he wasn't paralyzed, but the pain was overwhelming. He remembers handing over his insurance information in the ambulance. Again, once he got to the E.R. I had insurance, I figured that would sort itself out. I'm not thinking about anything but what happened to me and how is it going to get fixed, how bad is this? Reporter: After surgery to put a metal rod in his thigh and two days in the hospital, Buckingham received a second painful blow. Then it was like in passing at the end, by the way, you've been out of network this entire time. Reporter: As a medical professional, Buckingham considers himself knowledgeable about insurance. Since he was fairly young and healthy, he had a high deductible. That meant if he stayed in network, his out-of-pocket expenses would be $5,000. Out of network, $10,000. But Buckingham says when the hospital bill finally arrived, he was shocked. The first bill came through for $70,000. And I remember I just blew it off like, oh, they didn't get my insurance information. Reporter: $70,000, seven times his plan's out of network maximum. When Buckingham called his insurance company, they said the bill was correct. He says he kept pressing but never got a real explanation. I was like, wait a minute, did you just say in the same breath that I had a $10,000 out-of-pocket maximum? And that I owe $71,000? We will never take corporate pac money -- Reporter: It can even happen to the people making our country's laws. Democratic congresswoman Katie porter's appendix burst. I didn't call an ambulance because I knew it can cost a lot -- Hold on a second, you feel terrible, you don't call an ambulance because you know it may cost you money? Ambulances are one of the things that get surprise billed. I specifically had my manager drive me not to the closest hospital, but to the in-network hospital. Reporter: Even though the hospital was in-network, the surgeon who helped save her life was not, she got a bill for nearly $3,000. As a patient they expected you to be able to ask, before you save my life, are you in my network? Exactly. He wouldn't have known had I asked him, because there are hundreds and hundreds if not thousands of insurance plans out there. He's not going to know that, he's there to make sure I don't die of infection. How does that make you feel? Angry. Reporter: Nearly 80% of Americans want legislation to protect patients from these surprise bills. It's one issue with broad agreement from doctors' offices to hospitals, from halls of congress to the white house. They should be given a clear and honest bill, up front. Reporter: Republican senator bill Cassidy is a doctor, and his family has also been hit. What we're trying to do here is pull the patient out of the middle. If the doctors and the hospitals and the insurance companies want to go at each other, they can. Reporter: Cassidy authored one of several bipartisan bills now making their way through congress. But over the summer, ads began running that criticized some of the legislation. Imagine if the care we needed wasn't there when we needed it How challenging to come up with a solution that satisfies the insurers, doctors, providers? They're not going to be satisfied because somebody's going to make less money. Reporter: Republican senator Lamar Alexander is pushing a bill to lower out-of-pocket costs. He had hoped it would pass by the end of 2019, but it's still waiting to be debated. I think we will get it done. I think there's a surge of cooperation because people, senatorses know people want their out-of-pocket health care costs down. We have should ways to do it. We need congress to be the parent in the room here and say to the insurance companies, to the hospitals, to the she was service providers, stop. Reporter: But she's skeptical, with a surprise bill that ruined her family's finances. 2003, she faced a $50,000 bill after her newborn spent 24 hours in NICU. Ultimately the bill got resolved, but just by happenstance. There was a third-party lawsuit that we were absorbed into. And the bill was finally absolved. My husband and I felt we should not be held responsible. Reporter: Ever since, she's been pushing for reform. Even testifying before congress. Meanwhile, accidents and diseases wait for no one. Rosenthal has some advice. The first thing I tell people is, don't write the check. You do have some options here. Everyone should know if their state has a law about surprise if it does, youshould invoke it. When people are surprised and it's uncomfortable in health care, you can negotiate. A lot of these providers know that the fees are crazy high. And if you come in and say, hey, I know the bill was $30,000, I'll give you $5,000, no questions asked, they'll often say okay. Reporter: For cyclist Brad Buckingham, facing that $70,000 bill, he had to hire a lawyer to get his bill drastically reduced to just a couple thousand. If I knew a cyclist that broke his hip today, called me and said, who do I talk to in the same situation? I'd have to say, a lawyer. I hopefy tell my story and tell it loud enough, that there's going to be change where this isn't an issue anymore.

This transcript has been automatically generated and may not be 100% accurate.

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