Even When Patients Plan Ahead A Significant Number Can Be Walloped By Surprise Medical Bills

The Associated Press: US Survey Finds Smaller Decline In Medical Bill Worries
The proportion of people in families struggling to pay medical bills is down, but the number isn’t dropping like it used to, according to a big government study. In a 2018 national survey, just over 14 percent of people said they belonged to a family struggling with those bills, the Centers for Disease Control and Prevention reported Wednesday. That’s a big drop from nearly 20 percent in 2011 but only slightly less than the proportion who reported the problem in 2016 and 2017. (Murphy, 2/12)

Reuters: Surprise Surgery Bills Happen Even When Patients Plan Ahead
Even among those who did their best to go where their insurance was accepted, 21% still got surprised by out-of-network bills. And tabs were not small, averaging more than $2,000. “We had no idea how often this actually happened or how damaging it could be,” said Dr. Karan Chhabra, of the University of Michigan Institute for Healthcare Policy and Innovation in Ann Arbor and Brigham and Women’s Hospital in Boston, who led the study. (2/11)

Modern Healthcare: 1 In 5 Patients Gets Surprise Bills For Elective Surgeries
Though states such as California, Connecticut, Florida, Illinois, Maryland, Massachusetts, Mississippi and New York have enacted varying laws protecting patients from surprise medical bills, all had proportions of surprise billing above the national median for elective surgery with an in-network facility and primary surgeon. “This suggests several hypotheses, including that these states may have been responding to endemic surprise billing problems, and that these policies may not have been completely effective,” the study authors wrote. (Cohrs, 2/11)

NPR: Surprise Billing Is As Common After Elective Surgery As In Emergencies
The study arrives during a time when Congress is debating how to address this problem. The two bills under discussion take differing approaches to resolving these outstanding payments when they’re no longer placed on the shoulders of patients. Either of the two bills would be an improvement over the status quo, Cooper says. But it’s unclear what measures will really make it into law. “The devil’s obviously in the details,” Chhabra says. (Renken, 2/11)

The Hill: House Panel Advances Bipartisan Surprise Billing Legislation Despite Divisions
The House Education and Labor Committee on Tuesday approved a bill to protect patients from massive “surprise” medical bills, but not before a vigorous debate that showed the divides within both parties on the issue. The vote of 32-13 sent the measure to the full House. But competing proposals must be reconciled before the chamber can vote on the issue, which is a rare area of possible bipartisan action this year. (Sullivan, 2/11)

Modern Healthcare: Second House Committee Falls In Line With Surprise Billing Compromise
The Ban Surprise Billing Act passed out of the Education & Labor Committee on a 32-13 vote with opposition from both parties. The vote leaves the House Ways & Means Committee as the lone dissenting voice advocating for an approach backed by hospitals and some physician specialty groups, with three other committees essentially united behind a proposal blending a benchmark payment with an arbitration backstop preferred by consumer groups and unions. (Cohrs, 2/11)

The Hill: Conservative Lawmakers Warn Pelosi About ‘Rate-Setting’ Surprise Billing Fix
Conservative Republicans came out against a bipartisan proposal that would end the “surprise” medical bills patients sometimes get from doctors and providers. In a letter to House Speaker Nancy Pelosi (D-Calif.) dated Monday, 39 Republicans, led by Rep. Andy Harris (R-Md.) warned against passing a bill that would impose what they see as “government-dictated price controls” on private negotiations between insurers and providers. (Hellmann, 2/11)

The Hill: White House Warns Of Raising Health Costs In Debate Over Surprise Medical Bills
The White House on Tuesday stepped farther into the contentious debate over legislation to protect patients from surprise medical bills, weighing in with a warning against one approach to the problem. A statement from the White House warned against the overuse of arbitration to resolve billing disputes, saying it could drive up health care costs. That means the White House is raising concerns with an approach from the House Ways and Means Committee in favor of a rival approach favored by both the House Energy and Commerce Committee and the House Education and Labor Committee. (Sullivan, 2/11)

Kaiser Health News: When Your Doctor Is Also A Lobbyist: Inside The War Over Surprise Medical Bills
When Carol Pak-Teng, an emergency room doctor in New Jersey, hosted a fundraiser in December for Democratic freshman Rep. Tom Malinowski, her guests, mostly doctors, were pleased when she steered the conversation to surprise medical bills. This was a chance to send a message to Washington that any surprise billing legislation should protect doctors’ incomes in their battle over payments with insurers. Lawmakers are grappling over several approaches to curtail the practice, which can leave patients on the hook for huge medical bills, even if they have insurance. (Pradhan, 2/12)

In other news on health care costs —

The New York Times: A $4 Million NICU Bill: The Price Of Prematurity
Eric Brown and his wife, Stacey, were stunned to learn that Stacey was pregnant again and even more surprised that not one — not two — but three more babies were on the way. “They were naturally conceived, so this was a complete and total surprise,” said Mr. Brown, 37, a high school special education teacher. He and his wife, who live in College Station, Texas, about 90 miles northwest of Houston, already had two children. The second trimester did not go smoothly: Ms. Brown developed infections that led to an unplanned cesarean section at the Woman’s Hospital of Texas in Houston. (Caron, 2/11)

The New York Times: ‘It’s Pretty Brutal’: The Sandwich Generation Pays A Price
When Tanya Brice’s mother moved into her apartment in Owings Mills, Md., five years ago, she was already caring for twin toddlers, one of whom has autism and an intellectual disability, and a teenage son. Brice, 43, is a single mom, and was supporting the household on a social worker’s salary. Her budget and schedule were stressed to the breaking point. Her mother, Janice, was medically fragile — she had hepatitis C and diabetes — and Medicaid wouldn’t pay for a home health aid, so that came out of Brice’s pocket, along with the money for higher electricity bills from her mother’s ventilator, and the extra food and necessities her mother needed. (Grose, 2/11)