President Trump wants Congress to thwart “surprise” medical bills that slam patients who seek the nearest ER in an emergency or carefully select a hospital, only to confront an out-of-network doctor who demands huge amounts for their services.
The White House sent a list of principles to aid bipartisan work on the problem, saying Mr. Trump views it as another fixable issue that’s withered on the vine in Washington.
“We are determined to end surprise medical billing,” Mr. Trump said at the White House.
According to Mr. Trump, any legislation should say that patients who scramble into an ambulance, yet wind up at out-of-network hospitals, do not have to pay more out-of-pocket than they would under their insurance plans.
In other cases, a patient might select an in-network hospital, only to receive care from an anesthesiologist or other provider who isn’t covered by his or her plan.
The administration said patients should be informed upfront whether providers are in or out of their network — and what costs they might face —and shouldn’t receive sudden bills from out-of-network providers they didn’t choose.
“We are going to hold insurance companies and hospitals totally accountable,” Mr. Trump said.
Mr. Trump also wants to avoid the type of situation faced by Drew Calver, a Texas teacher who made headlines when an out-of-network hospital treated him for a heart attack and sent him a $109,000 charge, or “balance bill,” reflecting the difference between what the hospital demands and what a health plan is willing to pay.
“I feel like I was exploited at the most vulnerable time,” Mr. Calver told the president.
“You look very good now,” Mr. Trump told him. “You don’t want to run for president, that I can tell you.”
Administration officials said they can point to “alarming” data on surprise billing and anecdotes from their personal lives, underscoring the scope of the problem.
Capitol Hill lawmakers have been working on the issue for months. The fight is bipartisan, with Sen. Bill Cassidy, Louisiana Republican, leading the way with Sen. Maggie Hassan, New Hampshire Democrat.
Senate Health Committee Lamar Alexander said he thinks Congress can deliver a bill to Mr. Trump by July.
Both parties have worked together on combating the opioids epidemic and — to some measure — slashing drug prices, though Republicans and Democrats disagree on whether to dismantle or build upon President Obama’s 2010 health care law.
Protect Our Care, a pro-Obamacare group, said surprise billing is a serious problem, yet “the Trump administration’s mission to wreak havoc on American health care has made the problem even worse.”
It cited Mr. Trump’s support for a state-drive lawsuit that, if upheld in appeals courts, would erase Obamacare — potentially before an adequate replacement is in place.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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