Democrats and Republicans come together to end surprise medical bills

Katie Porter while fighting through the pain of a burst appendix during campaigning and just weeks before election day in Irvine, Ca., texted her campaign manager that she needed to go to the hospital.

Even though there was an emergency room close by she asked to go to Hoag Hospital because she knew her health insurance would cover her since it was an in-network provider.

Six hours later she awoke from surgery to see the medical team around her in a panic.

They couldn’t get her temperature to drop or her blood pressure to rise and she would spend the next five days in the hospital recovering.

Roughly $55,000 worth of her hospital costs were covered by her Anthem Blue Cross insurance policy. However, a few days later, Porter said she received a roughly $3,000 bill from her surgeon. While the hospital she went to was in-network, the surgeon himself was not and her insurance company refused to pay.

“Apparently, to Anthem Blue Cross, $3,000 was too high a price to charge for saving my life,” Porter said in a Tuesday congressional hearing.

Rep. Porter’s surprise medical bill is a phenomenon that impacts 57% of American adults, according to a University of Chicago survey conducted last summer.

In the midst of a political showdown between Congress and the White House over issues ranging from subpoenas to immigration, lawmakers are currently considering bipartisan pieces of medical billing legislation that might ultimately make it to the president's desk. Two weeks ago, Trump announced his desire to see surprise medical billing legislation rolled out and within a week, Republicans and Democrats in both the House and Senate drafted bipartisan legislation to answer that request.

A number of 2020 presidential contenders have weighed in on this issue including Sen. Bernie Sanders whose re-launched Medicare-for-all proposal would provide government-run, Medicare-style health insurance for all Americans, outlaw most duplicative private insurance in the process and end copays, deductibles and surprise medical bills.

Several of his fellow 2020 presidential competitors have signed onto his bill in the past, including Senators Kamala Harris, Elizabeth Warren, Cory Booker and Kirsten Gillibrand.

Tuesday, the House Ways and Means Committee held a hearing with lawmakers, medical experts and health care trade association leaders to address the problem of surprise medical bills.

“I know both sides of the isle of Congress are interested in finding a solution that protects patients,” Rep. Devin Nunes, R-Calif., said.

In the Senate, lawmakers unveiled the STOP Surprise Medical Bills Act that would ban surprise medical billing for patients who visit an out-of-network provider in both emergency and non-emergency situations. The bill, which Louisiana Republican Sen. Bill Cassidy has been working on for nearly a year, would have patients pay the same cost as if they went to an in-network provider.

According to the lawmaker's office, providers would automatically be paid by the insurer the difference between the patient’s in-network cost-sharing amount and the median in-network rate for these services. Providers and plans could appeal this payment amount through an arbitration process.

"Patients should be the reason for the care, not an excuse for the bill," Cassidy said in a statement. "This is a bipartisan solution ensuring patients are protected and don't receive surprise bills that are uncapped by anything but a sense of shame."

The No Surprises Act, which was drafted by the House Ways and Means Committee, is similar to Cassidy’s proposed legislation but leaves out the independent arbitration process which the White House has said it doesn’t support.

Reps. Joe Morelle, D-N.Y., and Van Taylor, R-Texas, released their own piece of bipartisan legislation that would give providers and plans 30 days to participate in negotiations about medical costs. If they do not come up with an agreement, then the insurer must pay the provider a temporary payment. Either party could dispute the temporary payment from arbitration.

“Americans are already struggling to afford the continually increasing cost of health care – they shouldn’t be blindsided by unexpected and hyper-inflated medical bills when they unexpectedly need to see out-of-network providers,” Taylor said. “Reducing out-of-pocket health care cost isn’t a partisan issue and I am proud to come together with Representative Morelle to introduce this commonsense proposal that will end surprise billing and give more certainty to our constituents."

According to a recent ABC News/Washington poll, Americans by a 17-point margin say Trump’s handling of health care makes them more likely to oppose than support him for a second term.