Surprise Medical Billing Legislation: Issues for Congress to Consider

FACT SHEET

Legislative solutions are needed to combat the rising cost of health care in the United States, which accounted for almost 18% of the GDP in 2017. One symptom of the problem, surprise medical bills, contributes to unpredictable, high out-of-pocket costs for consumers. Patients often encounter surprise medical bills when receiving emergency or ancillary health services from out-of-network practitioners. These providers “balance bill” patients for the difference between the full charge for services and the amount paid by the insurer, or bill for the entire amount of undiscounted charges. Payers, providers, facilities, and health consumers are all stakeholders to consider in legislation to address surprise medical bills. In protecting consumers, policymakers should not fuel health care inflation.