Lawmakers Must Control Surprise Medical Bills

April 16, 2019

The Republican-controlled Legislature hasn’t done much to promote better health care in Texas in recent years, but lawmakers are finally acting in this session. Legislation is moving through the House and Senate to control the so-called surprise bills that are harming so many unsuspecting patients.

These bills occur when doctors and hospitals shift onto patients the out-of-network charges that insurance companies won’t pay. Those patients had no idea this would happen. They sought treatment from an approved health-care provider and believed, with good reason, that their insurance would cover it. If patients want to challenge these invariably high bills, they have to initiate a mediation process. Many don’t have the time or ability to undertake that challenge.

This is a nationwide problem, and many state legislatures are stepping up to protect their residents. Unfortunately, health economists have called Texas one of the worst states for this phenomenon. Congress is considering action at the national level, and that’s needed, too.

In Texas, SB 1264, filed Sen. Kelly Hancock, a Republican from suburban Fort Worth, would prohibit that kind of billing in emergency rooms. It would also protect patients with state-regulated plans from receiving surprise bills if they had no choice regarding who treated them for other types of care. A companion bill was sponsored in the House by state Rep. Trey Martinez Fischer, D-San Antonio. It’s good to see both parties getting behind this effort. Gov. Greg Abbott has also signaled his support for patient protection.

These bills do not have to harm doctors or hospitals either. They are more able to ensure that the health care they provide comes from in-network sources for consumers. Sometimes, they may simply go out of network for convenience. If they know that these extra costs will end up with them instead of the patient, they will be more motivated to avoid that headache from the start.

Both chambers need to keep these bills moving forward and make sure they don’t fall victim to the late-session tricks that are sometimes used to thwart legislation like this. If you think those maneuvers are often orchestrated by lobbyists with compliant lawmakers, give yourself a gold star.

This effort has broad support among voters and lawmakers. It needs to end up in a bill that lands on the governor’s desk after the session ends in May.