Trump vows to end balance billing

President Donald Trump on Wednesday threw his support behind curbing balance billing practices, saying his administration has "stopped a lot" of industry pricing tactics already.

"We're going to stop all of it, and it's very important to me," Trump said as cameras rolled during the portion of a roundtable discussion on healthcare with his top deputies and patients from around the country with stories of unexpected high medical costs.

Senators from both parties are currently working on legislation to stop insurers and hospitals from leaving patients to foot the bill for high and unexpected medical bills.

Labor Secretary Alex Acosta and HHS Secretary Alex Azar both touted policies already implemented by the administration, including last year's new expansion of association health plans to the new requirement for hospitals to publish the prices of procedures and the forthcoming final rule for drug makers to disclose their list prices on their TV ads.

Hospitals needed to start posting their prices Jan. 1, with huge variance in how they do so and usefulness for patients since the mandate from the federal government only that the prices must be listed in "machine-readable" format.

While some hospitals now link to their charges from their websites, others are bending the rules. San Francisco's Sutter Health for example published its prices as indecipherable script that a representative called a "machine-readable format that complies" with the HHS regulation.

On drug pricing, Trump wondered out loud at the steep differences in costs between brand-name drugs and their generics.

"Somebody's going to have to explain why they're paying for the brand," he said. "There's literally no difference."

Azar blasted pharmacy benefit managers and the role rebates play in nudging patients toward the more expensive brand-name drugs.

Acosta gave details of early takers for association health plans, or AHPs, saying about 30 AHPs have formed since the administration finalized its rule expanding them, and two are running across multiple states. In particular he highlighted the Las Vegas Metro Chamber of Commerce AHP comprising 500 employers and 100 sole proprietors. They have locked in a two-year rate that covers treatment of pre-existing conditions and offers vision and dental coverage as well, according to the secretary who praised AHPs as offering quality coverage at a lower price point.

"Small businesses where employees used to pay $400 per month for healthcare are now on average paying $230 per month," or a 40% reduction, Acosta said.

The expansion of AHPs has met mixed reaction at the state level. Twelve Democratic attorneys general sued to block the rule from taking effect. State insurance commissioners have been at odds over these plans should be regulated. And early adopters of these plans have defended the quality of the coverage.