Health Care Update from Capitol Hill

The week of February 10, a group of insurance advisors met with many senators and congressional leaders to hear the most current status of health industry issues facing the House and Senate in the early months of 2020.

Though absent from the year end spending bills passed in the last days of 2019, an end to surprise medical bills may arrive as early as the coming spring. There are 2 pending bills both in the House, one from the Ways and Means Committee, the other from the Education and Labor Committee. Though similar in effect, the methods for paying providers in the case of out of network services provided during an otherwise in network procedure differ between the bills. Jane Anderson of AIS Health notes the main difference in approach:

“Education and Labor, which approved its bill on Feb. 11 with a bipartisan majority, would set payments for providers by basing them on regional benchmarks, while still giving providers the option of going to arbitration for bills higher than $750. Ways and Means, meanwhile, backed mediation between insurers and providers to set rates, again on a bipartisan vote. That panel also threw in a new twist: a provision designed to rein in private equity firms that have purchased physician practices.”

In addition to a majority in favor of ending surprise billing, there seems to be a large number of current leaders opposed to a ‘Medicare for all’ model, citing cost barriers and stymied impact on the employer insurance market as well as the larger healthcare industry. There is also bipartisan support for strengthening and stabilizing the insurance marketplaces operated in all states, created by the ACA.

We may see progress on surprise billing soon. The fast approaching Presidential election will be the focus for many, and the outcome will no doubt have a large impact on the items remaining on the Congressional agenda.