Sen. McConnell Must Shut the No Surprises Act’s Door to Socialized Health Care
As Congressional leaders go down to the wire on Covid-19 relief and a year-end spending bill, one thing is certain: now is worst time for the surprise “killing” of our health care system. By attaching the No Surprises Act – a highly-flawed and one-sided “solution” to surprise medical bills – to an omnibus package, Senate Majority Leader Mitch McConnell would be agreeing to socialize health care in America. And he would be doing so not only on the eve of Georgia’s Senate runoffs, but also counter to dire warnings from his own caucus, patients, hospitals, and physicians, and conservative organizations nationwide.
Leader McConnell has so far resisted misguided calls to add this legislation, and he should be widely applauded for doing so. He should now remain committed to keeping it out and rebooting the debate over this critical health care issue in the next Congress.
The No Surprises Act opens the door wide open to socialized health care because it clearly tips the scale in favor of the nation’s mega health insurance plans. Commenting today on the independent dispute resolution (IDR) codified in the bill, the National Taxpayers Union warned, “By requiring arbitrators to consider the consider the median in-network rate and banning them from considering billed charges, the committee does indeed risk ‘working the refs’”. This type of “rigged” IDR would result in insurance companies winning a surprise medical bill dispute every time. Going forward, these insurers would then be able to drive their in-network rate lower and lower, thereby artificially fixing prices across the country completely in favor of their bottom lines.
The results of this socialized, downward spiral would be ruinous. Independent physician practices nationwide would lose all last vestiges of negotiating power and be forced to close. The ensuing provider consolidation would quickly accelerate, leading to skyrocketing prices for patients and vast restrictions on their access to care.
If one has been following the debate since this 372-page bill was dumped late last Friday night, the deep and widespread opposition to slipping this legislation into the end-of-year spending deal is overwhelming. The dreadful process behind introducing this bill, moreover, has only magnified the need for all stakeholders to have more time to analyze its many drastic implications. The push to rush this enormous bill at the height of pandemic is incomprehensible, especially given how controversial it is.
As Republican senators stated in a letter to Leader McConnell, “Any surprise medical billing legislation that includes rate setting or artificial limits that act as rate setting should not be included in any spending or legislative package before the end of the 116th Congress.” In addition, as a coalition of conservative leaders wrote to McConnell yesterday:
“We urge you to remain steadfast in your opposition to including the No Surprises Act in any year-end package. This bill is rife with problematic language and will lead to dangerous unintended consequences, right in the middle of a surging pandemic. It has nothing to do with Covid-19 relief or government funding. As you know well, bad process leads to bad policy.”
State medical societies are also rightfully up in arms. As just a small sampling, it is worth reading the statements from the Florida Medical Association, the Pennsylvania Medical Society, and the Medical Society of the State of New York to see what the legislation really calls for – and sadly would do.
Our nation’s hospitals have also expressed serious concerns. It is baffling how Congress would even consider endorsing this bill at a time when these facilities have been battered by the coronavirus. In a letter to Senate and House leaders, the American Hospital Association (AHA) explained, “We strongly oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills and impact access to hospital care, particularly in rural communities.”
Finally, the American Medical Association (AMA), the “House of Medicine”, issued an extremely timely and comprehensive letter yesterday to Leader McConnell stating the many problems embodied in the No Surprises Act. According to AMA Chief Executive Officer James Madara:
“We oppose enactment of the bill in its current form because it would significantly disadvantage already stressed physician practices, particularly small physician practices that may not have the resources to take advantage of the IDR process to obtain fair compensation for their services.
Back to the dreadful process, Dr. Madera also stated, “We also have significant concerns with the limited opportunity for stakeholders to thoroughly vet this consequential bill prior to its inclusion in an end-of-the-year legislative package and seek meaningful input from our practicing physician members.”
At the end of the day, when our most vulnerable patient populations are already bearing the brunt of this Covid-19 crisis, it is inconceivable that Congress would want to add to their suffering. Yet, as the Association of Mature American Citizens (AMAC) highlights in their recent call to action, implementing the No Surprises Act right now would do just that.
With such major implications for our health care system, Sen. McConnell must close the door to socialized medicine this week by rejecting the No Surprises Act. Much work remains to be done on this bill. A new Congress, appropriate deliberation and hearings, and language revisions that level the playing field, so all parties are treated fairly make the recipe for success next year.
Christopher Sheeron is President of Action for Health
