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Walberg, Subcommittee Examine Solutions to Protect Patients from Surprise Medical Bills

April 2, 2019
Press Release

Washington, D.C.—The Subcommittee on Health, Employment, Labor, and Pensions, where Congressman Tim Walberg serves as Republican Leader, held a hearing on Tuesday to examine solutions to protect patients from surprise medical bills, which ranks among Americans’ leading health care concerns.

“The high and rising cost of health care is a significant worry for families, workers, and employers across the country. Concerns about high premiums, high deductibles, and drug prices are known and well-documented, but the issue of surprise billing has rapidly risen to the forefront of peoples’ worries when it comes to health care,” said Walberg.

Unexpected medical bills cause a significant amount of financial stress for workers and families, many of whom may not have the funds set aside for this unforeseen expense. Patients deserve access to clear and comprehensive information about their health care coverage so that they can avert an unexpected bill.

“Surprise billing, sometimes called balance billing, happens when a patient visits an out-of-network care facility, or even when they are at an in-network facility but are seen by a doctor who is not in their network,” Walberg continued. “The story of surprise billing may go something like this: A worker who’s having trouble breathing visits an emergency room at a hospital in his health insurance network. While there, he receives an X-ray of his chest and is seen by a doctor who prescribes medicine to ease the strain on his lungs. Following the visit, he gets a bill – a high bill – for the trip to the emergency room. Even though the hospital was technically in-network, the doctor who saw him was not, leaving him to pay for the cost of the treatment.”

Federal policy solutions to remedy surprise billing should expand patient choice and safeguard employer-sponsored health coverage offered under the Employee Retirement Income Security Act (ERISA). About 110 million individuals receive high-quality insurance through an employer-sponsored plan under ERISA.