No Surprise! Lobbyists Block Congressional Efforts To End Surprise Billing

Lawmakers continue to display hesitancy when it comes to reining in payments to hospitals and other providers.

The point Ramesh Ponnuru, a fellow at the conservative American Enterprise Institute, makes in a Bloomberg opinion piece this morning is that if Congress can’t effectively put an end to surprise billing, how can it overhaul the entire health care system? Surprise billing has been garnering headlines and stories that outrage the public for over a year, after all.

What’s garnering more headlines these days is the call for Medicare for all. But that would curtail payments to providers even more than proposed legislation that would tackle surprise billing.

In regard to surprise billing, a bill by Sen. Lamar Alexander “would create a 60-day arbitration process to determine what insurers should pay out-of-network providers, and instructs arbiters to first consider the 80th percentile of list prices for a service in a given market,” writes Ponnuru.

However, the House is watering down its own version of a bill to end surprise billing, essentially making it toothless by keeping provider payments at today’s rates.

“If medical-provider lobbies can force Congress to back off from addressing surprise bills—which are, in the grand scheme of our health care system, a small kink—what are the odds lawmakers will force a much larger group of providers, including the powerful hospitals lobby, to accept the much larger reductions that Medicare for All would have to entail?”

Slim to none?