The growth of surprise out-of-network medical bills has risen to be a top health care concern for many people in the U.S. Surprise medical bills can happen to anyone, no matter what kind of health insurance they have. When patients inadvertently use providers that are not in their health plan’s network, they are directly billed by these providers the difference between what their health plan agrees to pay and what the provider charges. Such a practice is known as surprise balance billing and it can add up to hundreds or thousands of dollars, leaving patients with little recourse and potentially devastating medical debt.

It is important to devise policies that will put a check on the growing monopoly power of providers as well as protect consumers. Ending surprise medical bills is a policy solution that has the potential to do both. Toward that end, our new report, “Ending Surprise Balance Billing: Steps To Protect Patients and Reduce Excessive Health Care Costs” lays out what we see as the essential elements of federal and state policy solutions to the surprise-out-of-network bill problem, and that addresses both consumer protection and monopoly power.

We hope our recommendations are valuable to you and other stakeholders with a shared interest in taking practical steps to end surprise medical bills and working to lower health care costs overall.

Please do not hesitate to contact Quynh Chi Nguyen, Policy Analyst, at qnguyen@communitycatalyst.org with any questions or feedback.

Sincerely,
Michael Miller
Strategic Policy Director, Community Catalyst