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Lower Health Care Costs Act aims to end surprise billing

by Sen. Lamar Alexander (R-TN)

One out of five times Americans visit a hospital emergency room, they are surprised several months later to receive a bill that could run into thousands of dollars.

Last month (June), the U.S. Senate health committee by a vote of 20-3 approved legislation to end such surprise billing and to take other steps to reduce the amount of money Americans pay for their health care out of their own pockets.

The bipartisan Lower Health Care Costs Act of 2019, which I introduced along with Democratic Sen. Patty Murray of Washington state, includes 55 proposals from 65 senators — 29 Republicans and 36 Democrats — that would increase transparency in medical costs for patients and employers and increase prescription drug competition to lower the cost of generic drugs, which make up 90 percent of all prescriptions written.

State Reps. DeBerry and Lynn like the idea of ending surprise medical billing — but leave out “benchmarking.” To read the full piece, click the photo!

Instead of remaining stuck in a perpetual partisan argument over the Affordable Care Act and health insurance, senators are working across party lines to lower the costs of what Americans pay for health care out of their own pockets.

The reason for this surge of cooperation is that health care costs are the biggest financial concerns of Americans, according to Gallup, and up to half of the $3.5 trillion Americans spent on health care in 2017 may have been unnecessary, according to testimony before the Senate health committee from the National Academies. 

That’s as much as $1.7 trillion spent unnecessarily — three times as much as we spend on national defense, 60 times as much as we spend on Pell Grants, and 550 times as much as we spend on national parks.

Warren Buffett has called the rising cost of health care “a hungry tapeworm on the American economy.”

This bill is the result of 17 committee hearings. Its 55 proposals include:

* Making sure you know the estimated price of non-emergency health care before having the procedure, because you should know how much you’ll need to pay for non-emergency medical procedures like a scheduled C-section or imaging tests like an MRI.

* Requiring that patients receive all bills within 45 days to ensure you do not get dozens of unexpected bill months after a hospital visit.

* Bringing cheaper generic drugs to market faster by increasing competition. Generic drugs are 90 percent of prescriptions and up to 85 percent cheaper when there is competition among brand drugs and generic drugs.

* Increasing transparency and helping consumers who have skin in the game by making more information available to employers and patients so they know how much they are actually paying for health care. You can’t lower your health care costs until you know what your health care actually costs.

* Banning gag clauses that prevent employers from helping reduce your costs. Some contracts with insurance companies and hospitals prevent employers from knowing that a knee replacement might cost $15,000 in one hospital and $35,000 at another hospital. Last year, Congress banned gag clauses that prevented pharmacists from telling you it is sometimes cheaper to pay cash instead of using insurance.

* Banning language in insurance contracts that prevents you from knowing the cost and quality of your doctors. Some contracts with insurance companies and hospitals prevent patients from knowing that the hospital down the road is less expensive and higher quality.

President Donald Trump and Health and Human Services Secretary Alex Azar are also taking steps to lower Americans’ health care costs, including by listing prescription drug prices in TV ads, exploring using tax-deductible Health Savings Account money to pay for direct primary care, and providing small businesses and self-employed Americans health insurance with the same cost advantages and coverage protections that employees of large companies enjoy.

The Lower Health Care Costs Act also includes a provision from Senate Majority Leader Mitch McConnell and Sen. Tim Kaine to raise the smoking age from 18 to 21. Helping keep Americans healthy is a major part of helping control health care costs.

The Senate should pass this bill and send it to the president for his signature this month. 

(Lamar Alexander, a Republican senator from Tennessee, is chairman of the Senate’s health committee. This op-ed first ran in the Tennessean.)


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