Newly released Senate legislation to curb surprise medical bills would allow third parties to settle billing disputes, a provision that could complicate passage because it is opposed by the White House and absent from a House draft. The Senate bill represents nearly a year of work led by Sens. Bill Cassidy (R-LA) and Maggie Hassan (D-NH). The Senate bill would have insurers pay out-of-network doctors and hospitals for the difference between a patient’s in-network cost-sharing requirements and the median in-network rate for their services. If either party wanted to appeal the amount, they could do so using an arbitration process.  [AEI’s Jim Capretta explains at RealClearPolicy why arbitration is not a good idea.]

Bipartisan legislation unveiled this week in the House would limit hospitals and doctors to charging health insurers local market prices for care that is outside a patient’s network, a measure intended to curb surprise medical bills. At a news conference last week, President Trump emphasized bipartisan support for a fix. The House Energy and Commerce Committee unveiled its “No Surprises Act” that would require patients be told which providers are out of their network and whether they could face additional charges. Lawmakers will be collecting feedback in the coming weeks to refine the bill.

President Trump announced Thursday his administration is working with Congress on a comprehensive legislative package to outlaw crippling surprise medical bills. The administration says it is aiming to increase transparency in health services billing. The president said that patients must be told ahead of treatment if a specialist, such as an anesthesiologist or radiologist, is out of their network. Patients should only be billed for out-of-network care if they consent to receiving treatment. “These bills have ruined people’s lives,” Trump said at the White House.

The Justice Department has appealed a federal judge’s decision to strike down work requirements in Kentucky and Arkansas pertaining to certain Medicaid beneficiaries. The case will go before the U.S. Court of Appeals for the District of Columbia after being struck down March 27 by Judge James Boasberg of the U.S. District Court for the District of Columbia, an appointee of former President Obama. At issue are rules the Trump administration approved in the states obligating some people who are able to work, volunteer, or take classes for 80 hours a month to be allowed to remain on Medicaid. The rules don’t apply to caregivers, parents, and people undergoing treatment for serious illness.

Arkansas Gov. Asa Hutchinson is asking the Trump administration to appeal a federal judge’s decision to strike down the state’s Medicaid work requirements. “I remain fully committed to the work requirement and we are in this for the long haul because we believe it is the right policy,” Hutchinson, a Republican, said in a press conference Thursday. Hutchinson said that he thought the judge’s ruling was wrong, and that he had just gotten off the phone with members of the Trump administration, who remained committed to the program.

Access to quality, affordable medical care should be something all elected officials can agree to work on because it’s something we all believe in, Rep. Westerman (R-AR) writes. The Fair Care Act has two primary goals: to increase the number of people with health insurance coverage and to decrease per person health spending. It’s a fair solution covering pre-existing conditions, tackling the cost of insurance premiums and increasing consumer flexibility.  Highlights:

  • Title 1: Private Sector Health Insurance Reforms
  • Title 2: Medicare and Medicaid Reforms that Promote Solvency and Increase Access to Health Insurance Plans
  • Title 3: Promote Transparency and Competition to Lower Prescription Drug Costs
  • Title 4: Increase Competition and Lower Costs by Discouraging Provider Monopolies
  • Title 5: Digital Health Care Reforms

Price controls in health care could be one of the major policy issues of the 2020 Democratic primary and a key way of differentiating the most progressive candidates on the Left from others seeking the nomination, but Republicans are posing the question as well. It should come as no surprise to find the outspoken champion for an incremental approach to single-payer health care, Sen. Michael Bennet, (D-CO), promoting government-set rates, but the fact that a Republican, Sen. Bill Cassidy, (R-LA), is joining him in leading the charge should concern conservative and moderate Republicans alike.

A new report from government actuaries has revealed that the Congressional Budget Office was scandalously off in its estimates of the impact of Obamacare’s individual mandate, a miscalculation that has had significant ramifications for healthcare and tax policy over the past decade.

Last year, Canadians waited a median of almost 20 weeks to receive specialist treatment after being referred by a general practitioner, according to a new report from The Fraser Institute. In practical terms, that’s the equivalent of getting a referral this week and waiting until May for treatment.

Such waits are endemic to government-run healthcare systems.

Canada’s single-payer system, which prohibits private insurance for medically necessary procedures, is a prime example of the pitfalls of total government control. Twenty weeks of waiting is bad enough. But some areas in Canada fare even worse. The median wait for treatment from a specialist following referral from a GP in New Brunswick is nearly a year.

After a federal judge in Texas declared Obamacare unconstitutional on what I saw as shaky legal grounds, I declared the decision an ” assault on the rule of law.” On Wednesday, I met with Rob Henneke, a lawyer for individual plaintiffs in the suit, who said that myself and other critics “missed the mark” in our analysis, and he explained why. Henneke, general counsel at the Texas Public Policy Foundation, who has been serving as attorney for the individual plaintiffs, has advanced an alternative theory that sees the requirement to purchase insurance (the mandate) as separate from the tax on going uninsured. All major differences flow from the way one views that distinction.