In many ways, consumers' cost and access problems are worse now than they were when Congress did try to take action two decades ago. Today they face much higher out-of-pocket costs than they did in the 1990s, despite the expansion of coverage under the Affordable Care Act. Both employer health plans and individual-market plans have steeply ratcheted up deductibles and coinsurance, while adopting narrower networks that may lack needed specialty providers.
Responding to growing public anger, congressional Democrats have offered a number of patient-protection bills that are likely doomed under the current administration. A broad measure spearheaded by Sen. Elizabeth Warren of Massachusetts, called the Consumer Health Insurance Protection Act, would prohibit surprise bills for ED care, shield patients from out-of-network bills if they rely on an inaccurate provider directory, and establish an ombudsman program to track consumer complaints about insurers.
Sen. Sherrod Brown of Ohio and Rep. Lloyd Doggett of Texas have filed bills to bar providers from billing patients for out-of-network bills unless the patients consented ahead of time to receive care from non-network providers. A bill sponsored by Sen. Jon Tester on Montana would allow states to regulate air ambulance companies, whose huge out-of-network bills have caused a furor in many states.
And Sens. Claire McCaskill of Missouri and Ben Cardin of Maryland are pressing the Trump administration to scrutinize whether Anthem's policy of refusing to pay for ED visits it deems unnecessary complies with federal law. Blue Cross and Blue Shield of Texas just implemented a similar approach.
Congressional Republicans have not joined them in these efforts, though some, like Sen. Roy Blunt of Missouri, have criticized insurers for refusing to cover ED visits.
The main bipartisan effort currently is a working group led by Cassidy that seeks to draft a bill to improve price transparency.
“I call it giving patients the power, and when you do that good things happen,” said Cassidy, who added that he's reluctant to support any regulation “that's burdensome to the system.”