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Hoyer: Democratic chairmen trying to bridge divide on surprise medical bills

House Majority Leader Steny Hoyer (D-Md.) said Wednesday that two Democratic committee chairmen are trying to work out their differences over a measure that would protect patients from surprise medical bills.

A bipartisan group of lawmakers has been pushing for months to pass legislation protecting patients from getting massive bills when they go to the emergency room and one of their doctors happens to be outside their insurance network. That effort was derailed last month when House Ways and Means Committee Chairman Richard Neal (D-Mass.) and ranking member Rep. Kevin Brady (R-Texas) proposed an approach that differs from the bill put forward by House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.) and Rep. Greg Walden (Ore.), the top Republican on the panel.

“Mr. Neal and Mr. Pallone are talking and the committee members are talking about the differences,” Hoyer told reporters when asked if he or Speaker Nancy Pelosi (D-Calif.) would step in to try to resolve the dispute. “It’s like infrastructure — there’s universal agreement that we need to deal with surprise billing. There obviously are differences with respect to how you deal with that, and they’re discussing that now.”

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Hoyer added that hopefully they can “resolve those differences and move ahead in a way that will protect patients.”

Backers of the Energy and Commerce bill have been frustrated with Neal for suggesting a move in a different direction, one that could make it difficult to bridge the gap between the two committees despite Hoyer’s comments.

Pelosi has said she hopes surprise billing legislation will be included in a health care package ahead of a May 22 deadline for renewing certain expiring health programs.

But an agreement on the legislation would need to be worked out before then.

A spokesman for Pallone said he had nothing to add to Hoyer’s comments.

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Neal told reporters that the issue was discussed at a chairmen’s meeting with Hoyer on Wednesday morning. Neal said he thinks “some sort of a merger” of his outline and the Energy and Commerce bill could happen, though he did not elaborate.

“We would like a bipartisan bill, we would also like a bicameral bill. We would also like some sort of a merger if possible,” Neal said.

Adding to the complications, the House Education and Labor Committee has been in discussions about putting forward its own bill.The chairman of that committee, Rep. Bobby Scott (D-Va.), did not give a firm answer Wednesday when asked if his panel would offer legislation, saying only that they are “still working on it.”

“We don’t want to put out something that further divides the situation,” he added.

Neal and Brady’s approach would be more favorable to doctors and hospitals, who have been lobbying hard against the Pallone and Walden measure, which has the bipartisan backing of Senate Health Committee leaders Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.).

The main point of contention stems from a dispute over how to figure out the amount an insurer will pay the doctor once the patient is protected from surprise bills. The Ways and Means proposal would give that decision to an outside arbiter, while the Pallone, Walden and Senate Health Committee legislation would set the payment rate based on the average payment in that geographic area, with the option to go to arbitration on some higher-cost medical bills.

Doctor staffing companies owned by private equity firms have been running millions of dollars in ads against the Pallone-Walden-Senate Health Committee approach, worried that it would lead to damaging cuts to doctors’ payments. 

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