“Legislation would help end medical bill sticker shock for patients and lower insurance rates for businesses”
AUSTIN, TX-The Texas Association of Business, Center for Public Policy Priorities, AARP Texas, Consumers Union and the National MS Society all strongly support SB 481 by Sen. Kelly Hancock, which was heard Tuesday in the Senate Business and Commerce Committee.
Balance billing occurs when a consumer receives out-of-network services and is directly billed by the provider for the balance of what the health plan did not pay. This commonly happens when the consumer or employee goes to an in-network hospital, yet the doctor providing care is out-of-network. These surprise medical bills not only create financial insecurity for the consumer, but drive up health care costs to the employer.
Surprise medical bills are the number one cause of bankruptcy and bad credit ratings; many of these are a direct result of balance billing. This practice can be particularly hard on the consumer when they receive care in an emergency room and have no ability to shop for providers in-network.
“Even Texans who buy good insurance and go to in-network hospitals can get hit with surprise, out-of-network medical bills,” said Stacey Pogue, senior policy analyst with the Center for Public Policy Priorities. “Consumers shouldn’t be left holding the bag when insurers and doctors can’t agree on prices.”
Consumers are currently seeing relief from balance bills through mediation if certain conditions are met, including a bill that exceeds $1,000, but the current process needs to be expanded. SB 481 will help eliminate the conditions in which balance billing occurs, including reforming the mediation process so that all balance bills are eligible for mediation.
“A medical emergency shouldn’t be followed by a financial emergency,” said Bob Jackson, director of AARP Texas. “Too often, surprise medical billing causes confusion and financial catastrophe for consumers. Senate Bill 481 builds on an existing mediation system to ensure that all Texans who get a surprise medical bill can find relief through mediation.”
“We appreciate Sen. Kelly Hancock taking on this issue,” said Bill Hammond, CEO of the Texas Association of Business. “It is our hope that the Legislature will recognize this serious problem and quickly pass this bill to address it. The practice is not fair for consumers and is not fair for businesses, who struggle to provide health insurance for their employees.”
“It’s often impossible for patients to avoid surprise medical bills during a hospital visit” said Blake Hutson with Consumer Union, the advocacy division of Consumer Reports. “This legislation gives consumers the peace of mind that they won’t get left with hundreds or even thousands in extra bills after an emergency.”
