Use Our Content This story could be republished totally free (details).
It could appear as if the Senate, or at the least sure key senators, have selected a means ahead to repair the nation’s “surprise medical bill” downside. But make no mistake: The door remains to be open to strive one other resolution.
Members of the Health, Education, Labor and Pensions (HELP) Committee permitted a sweeping measure Wednesday that tackles a variety of big-ticket well being care considerations. The 196-page invoice touches almost each side of the well being care trade, from reducing the value of pharmaceuticals and making a nationwide database of well being care prices, to rising vaccine charges and stopping youth tobacco use.
One factor the invoice particularly doesn’t cope with: the insurance coverage market and the Affordable Care Act, which might be why the huge bundle was voted out of the committee in simply over two hours with little debate. The Lower Health Care Costs Act of 2019, sponsored by HELP Committee Chairman Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), the highest Democrat on the panel, sailed via with a bipartisan 20-Three vote.
“You don’t have to preach the whole Bible in one sermon,” mentioned Alexander as he described his panel’s motion. “We picked out one important thing: reducing health care costs.”
Still, simply because the primary hurdle has been cleared doesn’t imply there’s room for hypothesis about what might occur between now and when it reaches the Senate ground. Alexander mentioned he’s hoping the invoice can be voted on earlier than the Senate leaves Aug. 2 for a monthlong recess.
Email Sign-Up
Subscribe to KHN’s free Morning Briefing.
The easy listening to capped a busy few weeks, as senators debated the mechanism that will be used to cease shock medical payments — the surprising and sometimes expensive fees sufferers face after they get care from a physician or hospital not of their insurance coverage community.
An earlier draft of the invoice outlined three choices to resolve disputes between payers and suppliers. There was an in-network assure, the place all the well being care suppliers at a hospital — whether or not the anesthesiologist or lab — should settle for in-network insurance coverage charges.
Another choice, also known as baseball-style arbitration, would have the well being plan and the physician — in the event that they couldn’t attain an settlement on reimbursement — current to an unbiased arbitrator their greatest affords for a way a lot a affected person’s out-of-network care ought to value. The arbitrator would select between the 2.
But one other strategy — benchmarking — finally made it into the formal draft. Here’s the way it works: When sufferers are seen by docs who aren’t of their community, the insurer would pay the suppliers the “median in-network rate,” which means the speed can be much like what the plan pays different docs within the space for a similar process.
At the markup listening to Wednesday, Alexander mentioned he initially most popular one of many different approaches, the in-network assure, however modified his thoughts when the Congressional Budget Office mentioned benchmarking would save more cash.
A gaggle of senators on the panel led by Sens. Bill Cassidy (R-La.), Maggie Hassan (D-N.H.) and Lisa Murkowski (R-Alaska) voted for the chairman’s alternative, though they’d advocated for arbitration. Cassidy made clear he continues to have reservations.
“This is entirely for the insurance companies,” he mentioned of benchmarking. “I’m surprised that my colleagues on the other side of the aisle running for president are OK with this.”
Neither of the 2 Democratic senators on the committee working for president, Sens. Elizabeth Warren (Mass.) and Bernie Sanders (Vermont), have been current however each voted no by proxy.
But it is usually not a completely settled challenge.
Cassidy and Alexander indicated that the door was nonetheless open to together with unbiased arbitration earlier than the bundle will get to the ground.
“We’re going to keep working on that the next three or four weeks. There are clearly opportunities to improve the bill and move in the direction Sen. Cassidy wants to go,” Alexander advised reporters after the listening to.
At the markup listening to Wednesday, the committee took a step towards Cassidy’s most popular imaginative and prescient for fixing shock payments. It handed an modification from Cassidy that will require insurance coverage corporations to publish correct lists of who’s in-network, so sufferers have a greater likelihood of avoiding shock payments.
“This bill is not as good as it should be,” Cassidy mentioned. “And I thank the chairman because he has offered to work between now and floor consideration on the surprise bills.”
The solely different amendment permitted by the panel, supplied by Sen. Tammy Baldwin (D-Wis.), would require drug corporations to report value will increase.
And regardless of Alexander saying early on that he didn’t wish to discuss concerning the particular person insurance coverage market or the ACA, some Democrats couldn’t let the chance cross with out mentioning Republican efforts to undermine it.
“Repairing the train can only get you so far if you are pulling up the track at the same time — and that’s unfortunately exactly what this administration is doing,” Murray mentioned in her opening assertion. “The biggest threat to families’ health care continues to be sabotage from President Trump.”
Use Our Content This story could be republished totally free (details).
Rachel Bluth: rbluth@kff.org”>rbluth@kff.org, @RachelHBluth
Related Topics Health Care Costs Health Industry The Health Law Legislation Surprise Bills U.S. Congress src=”http://platform.twitter.com/widgets.js” charset=”utf-Eight”>