Letter to the Editor: Proposed surprise medical billing legislation benefits insurance companies

Anyone who believes that private markets enable competition, drive efficiencies and reduce costs should be very concerned about the surprise medical billing “compromise,” STOP Surprise Medical Bills Act (S. 1531), making its way through Congress.

In theory, this legislation requires any disputes between insurers and providers over so-called “out-of-market” care to go to arbitration. That sounds reasonable until you dig into the details. Arbitrators would be required to first consider “median in-network rates” over all other factors. So if the median in-network rate for a procedure is X, then the arbitrator would be required to rule that a doctor or hospital receives X as payment. That’s not arbitration; it’s codifying rate-setting in federal law!

Also, consider who sets those in-market rates. It’s the insurance companies! This legislation would allow insurers to set the rates they pay to doctors and hospitals all across the country. That’s not how a free-market economy works.

Lastly, as payments from insurers inevitably shrink, local hospitals and doctors could go out of business, threatening patients’ access to care and the quality of care they receive. Congress must reject this “compromise.” It’s a giveaway to the big insurers at the expense of patients and providers alike.

Sarah Bennett