Obstacles remain for deal on surprise medical bills

Lawmakers on Sunday touted a bipartisan deal on protecting patients from surprise medical bills, but the effort still faces some tough questions before it can reach President TrumpDonald John TrumpLawmakers release defense bill with parental leave-for-Space-Force deal House Democrats expected to unveil articles of impeachment Tuesday Houston police chief excoriates McConnell, Cornyn and Cruz on gun violence MORE‘s desk.

While the announced deal was a boost to efforts to address the complicated issue, supporters still face opposition from powerful industry groups and need to secure the backing of congressional leaders, who have yet to sign on.

And the clock is ticking. Backers of the deal between House Energy and Commerce Committee Chairman Frank Pallone Jr.Frank Joseph PalloneOvernight Health Care — Presented by That’s Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Obstacles remain for deal on surprise medical bills This week: House impeachment inquiry hits crucial stretch MORE (D-N.J.), Energy and Commerce ranking member Greg WaldenGregory (Greg) Paul WaldenOvernight Health Care — Presented by That’s Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Obstacles remain for deal on surprise medical bills House GOP unveils alternative drug pricing measure ahead of Pelosi vote MORE (R-Ore.) and Senate Health Committee Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderOvernight Health Care — Presented by That’s Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Obstacles remain for deal on surprise medical bills Life after Yucca Mountain: The time has come to reset US nuclear waste policy MORE (R-Tenn.) are trying to include the measure in a year-end government funding package, which must pass before a Dec. 20 deadline.

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Key committee leaders are signing on, but the top Democratic and Republican leaders in each chamber have not endorsed the deal. And the American Hospital Association, an influential group in Washington, is also opposed, worried the measure would result in damaging cuts to payments to hospitals. Doctors and hospitals have been lobbying hard on the measure, and that work is likely to ramp up as the year draws to a close.

Protecting patients from getting massive bills when they go to the emergency room and one of their doctors happens to be outside their insurance network is a rare area of potential bipartisan action this year. Lawmakers from both parties have been negotiating for months, and President Trump has also encouraged those efforts. The White House on Monday praised the deal.

But whether the deal can actually become law this year could depend on the broader negotiations on government funding and health care measures like lowering drug prices and delaying taxes in ObamaCare, as well as on whether lawmakers can overcome staunch industry opposition.

Sen. Patty MurrayPatricia (Patty) Lynn MurrayOvernight Health Care — Presented by That’s Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Obstacles remain for deal on surprise medical bills Key House and Senate health leaders reach deal to stop surprise medical bills MORE (D-Wash.), the top Democrat on the Senate Health Committee, has notably not signed on to the deal.

“Senator Murray is working through members’ concerns and is very hopeful a final agreement can be reached that’s consistent with the goal she’s had throughout this process: ending surprise billing in a way that doesn’t shift costs back onto patients in other ways,” said Helen Hare, a Murray spokeswoman.

Senate Democratic Leader Charles SchumerCharles (Chuck) Ellis SchumerTikTok chief cancels Capitol Hill meetings, inflaming tensions Overnight Health Care — Presented by That’s Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Overnight Health Care — Presented by Johnson & Johnson — Democrats call on Supreme Court to block Louisiana abortion law | Michigan governor seeks to pause Medicaid work requirements | New front in fight over Medicaid block grants MORE (N.Y.) is also a major question mark. He has been sympathetic to objections raised by hospitals to the measure.

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His spokesman reiterated that Schumer wants a solution to the problem of surprise billing in general but did not weigh in on the latest specific proposal.

“Senator Schumer absolutely believes patients should be protected from surprise medical billing,” a Schumer spokesman said.

“This is one piece of many health care related proposals that are being considered by various committees in both chambers of Congress,” the spokesman added. “Senator Schumer believes you’ve got to look at all of them together as a whole to get the best deal for working Americans.”

One influential group in Schumer’s home state, the Greater New York Hospital Association, blasted the deal on Monday.

“This rush to get surprise billing language into an end-of-year funding bill, without regard to real-world consequences to health care providers, is dangerous and unnecessary,” the group said. “We encourage Congress to slow down and ensure that this important policy is done thoughtfully and correctly.”

Speaker Nancy PelosiNancy PelosiHouse Democrats expected to unveil articles of impeachment Tuesday Impeachment witness to meet with Senate GOP Tuesday Press: Pelosi strikes back, hatred is a sin MORE (D-Calif.) has also not commented on the deal, and Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellHouston police chief excoriates McConnell, Cornyn and Cruz on gun violence Overnight Health Care — Presented by That’s Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments GOP senators worry Trump made ‘problematic’ concessions in trade deal MORE (R-Ky.) said only that he is “reviewing” it.

The deal though includes a significant sweetener to try to win McConnell’s support, a provision to raise the legal age for buying tobacco products to 21, a major priority for the industry and the Senate GOP leader, whose state is one of the nation’s largest tobacco producers.

It is also unclear if other senators who were working on a rival surprise billing proposal will jump on board.

The key dispute for months has been how much insurers will pay doctors for a service once the patient is taken out of the middle.

The deal announced Sunday would set the payment rate based on the average amount that is paid for the service in that area. Doctors and hospitals have been pushing for a rival approach that would let an outside arbitrator decide the payment amount.

The new agreement moves slightly toward the doctors’ position by allowing high-cost bills — those that cost more than $750 — to go to arbitration, but doctors and hospitals are not satisfied.

A key group of lawmakers have backed the doctor-favored approach, including Sens. Bill CassidyWilliam (Bill) Morgan CassidyObstacles remain for deal on surprise medical bills Key House and Senate health leaders reach deal to stop surprise medical bills GOP senators unveil bill to expand ‘opportunity zone’ reporting requirements MORE (R-La.), Maggie HassanMargaret (Maggie) HassanObstacles remain for deal on surprise medical bills Key House and Senate health leaders reach deal to stop surprise medical bills Senators sound alarm on dangers of ransomware attacks after briefing MORE (D-N.H.) and Michael BennetMichael Farrand BennetObstacles remain for deal on surprise medical bills Key House and Senate health leaders reach deal to stop surprise medical bills Bloomberg on 2020 rivals blasting him for using his own money: ‘They had a chance to go out and make a lot of money’ MORE (D-Colo.), a 2020 presidential candidate.

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That group also has not endorsed the deal, though they said they are “encouraged” as the “final details” are worked out.

The deal also includes a range of other health care measures aimed at lowering costs, such as requiring drug companies to provide justifications to the government for large price increases and banning anti-competitive clauses that hospitals use in contracts with insurers.

Backers hope those will bring over enough votes to take the bill across the finish line.

“This agreement will make health care and prescription drugs more affordable for the American people,” Pallone said in a statement. “I’m hopeful that this bipartisan, bicameral agreement can be voted on quickly so that it can be signed into law before the end of the year.”

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