Patty Murray Joins GOP Senate Colleague In Targeting High Health Care Bills, Drug Costs
BY RACHEL BLUTH / KAISER HEALTH NEWS
In a year already marked by a wide variety of congressional health care legislation, Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., on Thursday released the details of a plan they hope will help bring down health costs and eliminate surprise medical bills for patients. Alexander and Murray are the chair and ranking member, respectively, of the Health, Education, Labor and Pensions Committee.
“These are common-sense steps we can take, and every single one of them has the objective of reducing the health care costs that you pay for out of your own pocket,” Alexander said in a statement. “We hope to move it through the health committee in June, put it on the Senate floor in July and make it law.”
It would be a mammoth piece of legislation, targeting nearly every area of the health care industry for reform, including surprise medical bills, prescription drugs, price transparency, public health and health information. Alexander said at a White House event earlier this month that he hopes to get the package to the Senate floor by the end of July.
“When you have a chairman and a ranking member that have worked together on a bipartisan package in the committee of jurisdiction, it always gives more weight to the product,” says Dean Rosen a former Republican senior health adviser and a partner at Mehlman Castagnetti Rosen & Thomas.
“Folks should take this package seriously,” he adds.
The draft bill released by the senators offers three options to curb surprise bills, those unexpected and often pricey bills patients face when they get care from a doctor or hospital that isn’t in their insurance network. It would use an independent arbitrator to settle disputes between insurance plans and providers and set a standard benchmark for physician pay, ideas that have popped up in other draft legislation circulating in the House and Senate.
The novel part from Alexander and Murray is the idea of an “in-network guarantee.” It would require that any hospital considered in-network for a health plan must promise that everyone working there is also in-network.
This would avoid situations in which patients choose a hospital because they know their insurance company will cover the bill, only to find out that one of the doctors they saw was out of network, leaving the patient with a hefty bill.
It also requires that labs and diagnostic tests be in-network, cutting off another avenue of surprise bills.
“From a policy perspective, there’s a rationale that this is the ideal approach,” says Loren Adler, the associate director of USC-Brookings Schaeffer Initiative for Health Policy.
Often called “network matching,” it’s an approach championed by the health insurance industry. James Gelfand, senior vice president for health policy for the ERISA Industry Committee, a trade group representing large employer benefits plans, named it specifically as a solution during testimony at a surprise bill hearing in the House Ways and Means Committee on Tuesday. Rep. Lloyd Doggett, D-Texas, has suggested something similar in bills introduced in this sessions and under the past two Congresses.
It’s possible that this option will upset physicians groups, as doctors risk receiving lower payments and having less leverage with insurance companies. Adler says these fears are mostly unfounded because hospitals have a vested interest in being fully staffed; they’ll step in if insurance companies try to lowball doctors.
Stakeholders such as industry trade groups, lobbyists and consultants will get a chance to air those concerns at a closed briefing on the draft on Capitol Hill on Thursday.
The Alexander-Murray proposal joins an array of efforts on surprise billing. The White House held an event featuring patients, several House committees have held hearings, and bipartisan groups in the House and Senate have proposed legislation, including a bill from Sens. Bill Cassidy, R-La., and Maggie Hassan, D-N.H. In add