Iowa’s Axne, Leads Freshman Dems In Push to End Surprise Billing

WASHINGTON – Representative Cindy Axne, D-Iowa, led a group of freshman House Democrats in introducing legislation to protect Americans from “surprise bills” due to out-of-date insurance directors.

The UPDATE Act requires insurance companies to regularly update their provider directories to prevent patients from unknowingly receiving out-of-network care.  

Its co-sponsors are Reps. Debbie Mucarsel-Powell, D-Fla., Susie Lee, D-Nev., Susan Wild, D-Pa., Haley Stevens, D-Mich., Abby Finkenauer, D-Iowa, Xochitl Torres Small, D-N.M., and Chrissy Houlahan, D-Pa.

“Patients should be able to trust that when their insurance company tells them a provider is in network, they won’t get hit with a surprise out-of-network bill,” Axne said in a written statement. 

“Middle-class families can’t afford to pay hundreds or thousands of dollars in surprise medical bills because an insurance company didn’t update their website. This common-sense legislation puts the onus on insurance companies to ensure patients are making medical decisions based on accurate information,” she added.

A recent Stanford University study found four out of 10 patients wound up being surprised with an out-of-network charge on a medical bill.

Axne said another study found 10 percent of providers listed in insurance company directories were either no longer in the company’s network — or had never been included at all.

Yet another recent study showed that surprise billing is on the rise, having increased from a 32% likelihood a patient would receive a surprise bill in 2010, to 43% in 2016. The average cost of surprise bills is on the rise as well, increasing from $804 in 2010, to $2,040 in 2016.

This bill makes it clear that insurance companies are responsible for updating the lists of which doctors, clinics and other health care providers are “in network” — and therefore covered by an insurance policy.

“Seeking the healthcare you need shouldn’t come with a price tag you weren’t expecting,” Rep. Torres Small said. “Surprise billing hurts the pocketbooks of hardworking families and part of the solution is addressing the inaccuracies consumers face when researching in-network providers.

“The UPDATE Act will help improve transparency of in or out-of-network status by requiring insurance companies to maintain their provider list as up-to-date as possible. By providing improved information to patients, families can better plan their upcoming medical costs and lessen the headache of an unexpected medical bill,” she said.

“Health care in this country is already expensive enough, and for any person to receive a surprise bill from a provider that they were led to believe is in their network is a burden that no American deserves,”  Rep. Susie Lee said. “This is an issue that Democrats and Republicans should agree needs to be fixed. I am proud to help introduce this bipartisan bill with Congresswoman Axne as I continue to fight to give every southern Nevadan and every American access to affordable, quality health care.”

Axne said she’s hopeful a reform package that addresses surprise billing will emerge in coming months. But in the same breathe she noted in a recent interview that her bill has already garnered bipartisan support and is ready to go.

“If we can take pieces out that we know have agreement and we can move that forward and actually make a difference, then we should take every opportunity to do that,” Axne says.

Sen. Chuck Grassley, D-Iowa, is co-sponsoring a bill with Sen. Bill Cassidy, R-La., in the Senate intended to jumpstart discussions in Congress about how to best stop the use of balanced billing to charge patients for emergency treatment or treatment provided by an out-of-network provider at an in-network facility.

“No one should receive surprise medical bills. This draft legislation will add transparency and fairness to health care costs. I look forward to this important consumer protection becoming law,” Grassley said recently.

“Patients should have the power, even in emergency situations when they are unable to negotiate,” Cassidy said. “Our proposal protects patients in those emergency situations where current law does not, so that they don’t receive a surprise bill that is basically uncapped by anything but a sense of shame.”