1. Background
  2. Economic Justice

FCNL Supports Surprise Billing Legislation at the Federal Level

By Michelle Caughey, February 18, 2020


Surprise medical billing has gotten out of hand. FCNL is strongly in favor of legislation that would protect patients from unaffordable and unanticipated medical bills.

What is surprise billing?

Health insurance generally covers emergencies and care provided through “network” or contracted physicians, hospitals and other providers. Patients getting emergency care may find themselves surprised by a bill not covered by their insurance company, especially in certain specialties like radiology, pathology or ambulance services. Patients are then responsible for paying for services of which they had no prior knowledge, often at markedly inflated prices.

How big is the problem?

Two-thirds of Americans are worried about being able to pay a surprise bill.

An estimated 20 percent of U.S. emergency room visits, 9 percent of inpatient admissions, and more than half of ambulance or air-ambulance transports involve an out-of-network provider. According to the Journal of the American Medical Association, two-thirds of Americans are worried about being able to pay a surprise bill.

Why do we need a national law?

More than half of the states have enacted laws to counteract surprise billing, but these laws do not extend to insurance plans that are governed by federal law. Therefore, a national law is needed to cover everyone.

A solution: surprise billing legislation.

According to Kaiser Health News, 78 percent of Americans support surprise billing legislation. It has support from both sides of the aisle, too, as bipartisan bills passed in the House and Senate in 2019. It looked like Congress would enact legislation, but heavy lobbying from private equity groups and special interests derailed the effort. Instead, a watered-down bill that relies on “independent dispute resolution” has been introduced. The way forward for passage of surprise billing legislation remains unclear.

Surprise medical bills remain a serious concern for Democrats and Republicans. FCNL favors a comprehensive and just solution, which protects patients from unaffordable unanticipated medical bills and reimburses providers at reasonable rates while keeping insurance rates affordable for all.

Health Care 

Ensuring access to affordable, quality health care is the very definition of a public good—a service that can’t be adequately provided by private interests but that is necessary to benefit everyone.

Michelle Caughey

  • Friend in Washington

Michelle is the current Friend in Washington. She is a retired internist and was a high-level administrator at Kaiser-Permanente in California.