The ongoing COVID-19 pandemic has amplified the urgency for robust surprise medical billing protections. In the United States, over 6 million individuals have contracted the coronavirus, leading to hundreds of thousands of hospitalizations and tragically, over 189,000 deaths. This health crisis coincides with widespread economic instability, potentially altering how Americans access healthcare, including increased utilization of urgent care centers and freestanding emergency rooms, where out-of-network providers are more common.
Federal legislation is crucial to comprehensively shield commercially insured individuals across all plan types from the financial burden of surprise medical bills. While numerous states have implemented surprise billing safeguards for insured individuals within their jurisdiction, and some have enacted emergency measures during the pandemic, limitations persist. These gaps leave many still vulnerable to unexpected and exorbitant medical expenses.
Simultaneously, private equity firms have sought and received substantial interest-free loans from Medicare under the guise of COVID-19 relief for healthcare providers. Despite accepting these funds intended to help doctors and hospitals navigate the pandemic, some firms have continued practices that prioritize profit maximization, such as provider layoffs and salary/hour reductions. Although private equity lobbying against surprise billing protections has lessened somewhat during the pandemic, these groups remain largely resistant to existing legislative compromises and have indicated a willingness to reignite their opposition to proposed solutions.
The Escalating Costs of Surprise Billing: A Hidden Health Crisis
Despite limited legislative and administrative actions aimed at curbing surprise bills and the already substantial expenses associated with COVID-19 testing and treatment, many Americans are still reporting unexpected out-of-network bills stemming from inflated charges. This persistent issue underscores a systemic problem within the healthcare system.
Beyond individual cases, surprise medical billing significantly inflates overall healthcare expenditure. Research by Cooper and colleagues reveals that surprise billing has driven up health insurance premiums by over 3 percent, translating to an estimated $40 billion annual increase in national healthcare costs. This hidden cost impacts everyone, raising premiums for employers and individuals alike, regardless of whether they have personally received a surprise bill. This increase in premiums ultimately results in reduced wages and less disposable income for American families, a particularly concerning consequence during economic downturns.
Congressional efforts to eliminate surprise billing offer a tangible solution to mitigate these economic burdens. Proposed legislation is projected to generate billions of dollars in savings and slow the growth of health insurance premiums. These savings would provide much-needed financial relief to families and the broader economy.
“Congress now has a critical opportunity to deliver comprehensive protection to American consumers and families against surprise medical billing – an action that is long overdue,” stated Mark Miller, Executive Vice President of Health Care at Arnold Ventures. “By acting decisively, they can close this loophole, frequently exploited by private equity, which burdens families with debt and drives up healthcare costs for everyone.” Taking action against surprise billing is not just a matter of consumer protection; it is a necessary step towards a more equitable and affordable healthcare system.
