Sending Office: Honorable Lloyd Doggett
Sent By:
Afton.Cissell@mail.house.gov

Sponsor The End Surprise Billing Act (H.R. 861)

Current Sponsors: Cartwright, Case, Chu, Cicilline, Cohen, Courtney, D. Davis, S. Davis, DeGette, DeLauro, Espaillat, Garamendi, Grijalva, Higgins, Hill, Jayapal, Kaptur, Kelly, Khanna, Kuster, Langevin, B. Lee, Lewis, Lipinski, Moore, Norton, Pingree,
Pocan, Porter, Schakowsky, Velazquez, Welch

Even prudent and careful patients, who seek to ensure all medical services anticipated during a hospitalization are covered within the network of their health insurance can be surprised with big, out-of-network bills.  Surprise medical bills are crippling
the wellbeing of too many patients.  When the patient is trapped between the insurer and the health provider, the patient should be held harmless.  This is an issue on which I have been working for 4 years. 

While some have begun to address this problem, states are offering a patchwork of protection. A federal solution is necessary to regulate ERISA self-insured plans.  In Texas, for example, that means about 40% of all insured have no protection from surprise
bills.  See the below
NBC News story
on the burden patients are facing and sponsor The End Surprise Billing Act to protect patients from these bills.

To learn more about this issue and sponsor this legislation, please contact Afton Cissell on my staff (Afton.Cissell@mail.house.gov, 5-4865).

Sincerely,

Lloyd Doggett

Transcript:

There is breaking medical news tonight. the FDA has just approved the first drug to treat postpartum depression which affects some 400,000 women each year. Doctors call this a game changer, and we get details from NBC’s Kristen Dahlgren.

Reporter: After the birth of her first child, Stephanie Hathaway knew she had more than just baby blues.

I just thought oh my goodness, if I put the baby down, I might hurt myself.

Reporter: She was diagnosed with postpartum depression, a condition that affects one in nine women in the U.S. even using antidepressants, it took months for her to feel better. Nothing was helping after the birth of her second daughter. desperate, she enrolled
in a freestyle for a new medication called Zulresso, a completely new class of drug designed specifically for postpartum depression. It’s a one-time infusion given in a hospital setting for two and a half days. Stephanie noticed a difference within hours.

I woke up from a nap, and the thoughts were gone, and they never came back.

Being able to treat people quickly within days is unlike anything we’ve ever been able to do before.

Reporter: 70% of women given the infusion improved significantly. 30 days later, they were still feeling good. for Stephanie and her girls –

Hadley said, “Mommy, you’re back. And I said, “Yeah, I’m here.”

Reporter: It’s been life changing. Kristen Dahlgren, NBC news, west Hartford, Connecticut.

Now to our investigation into a growing problem across the country, so many Americans hit with surprise medical bills, even if they have insurance. Now as our Denver affiliate Kusa first uncovered, collectors are coming after people’s paychecks and their
homes. NBC’s Stephanie Gosk explains how to avoid them in tonight’s “Your money, you life.”

Reporter: Racing to the emergency room, few people stop to think about the bill. Not Nicole Briggs. suffering from appendicitis, she called first to make sure this Denver hospital accepted her health plan.

They said yep, we take your insurance. Come on over.

Reporter: Once there, she kept asking. and each time you asked, they said?

Yes, that they take my insurance.

Reporter: Except no one told her the surgeon may not. two months later, the doctor sent a whopping bill. And the insurance company said she had to pay it.

I was so frustrated with it. I thought I’m just going to let this die in collections. I’m not going to pay this.

Reporter: It didn’t die. two years later, the collections company started docking her pay 25% and slapped a lien on the young mother’s home.

This is really scary.

Reporter: NBC’s Denver affiliate Kusa investigated and discovered that since 2017, that one collection agency alone put liens on 170 local homes, which means the owners may not be able to sell their homes until the debt is paid. We found similar cases of
liens in at least six states. a major factor, surprise medical bills. a recent poll found four in ten Americans have received one.

This practice is incredibly common, has become more so recently. And it affects tens, if not hundreds of thousands of Americans every year.

Reporter: When we asked who was to blame in Denver, the finger-pointing started. The doctor blamed the insurance company. the hospital blamed the doctor.

I think there is shared responsibility for the faults in our system, which are many.

Reporter: Did the hospital that Nicole Briggs went to have a responsibility to tell her you might actually be getting treatment from someone who is out of network?

That is absolutely an obligation that we are willing to make as hospitals.

Reporter: The other problem is doctors charge even higher prices to patients outside of the doctor’s insurance network.

Physician groups see this as a way to make extra money, really, on the backs of patients.

Reporter: So what can patients do? Call your insurance company to make sure the hospital and the doctors are covered. Something Briggs now wishes she had done.

They’ve made money off of me during one of the most vulnerable days of my life.

Lester, the hospital says that it encourages the doctors to take their insurance, but they can’t force them. While the industry tells us prices are driven up when doctors don’t join their plans. Meanwhile, federal legislation has been proposed to fix the
problem and take patients out of the middle.

A story what is going to ring familiar in a lot of households. Stephanie, thank you very much.

Related Legislative Issues

Selected legislative information: HealthCare

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