Ex-HHS chief threatens to vote ‘no’ on surprise medical billing measure

Rep. Donna Shalala (D-Fla.), a former secretary of Health and Human Services, said Friday she plans to vote against a bipartisan measure to protect patients from surprise medical bills unless it is changed. 

The comments from Shalala are a sign of the divisions within both parties over the legislation.

Shalala said she is worried the bill from House Education and Labor Committee Chairman Bobby Scott (D-Va.) and ranking member Virginia Foxx (R-N.C.) would harm hospitals in her district. 

The bill is slated for a vote in committee next week, and Shalala indicated other lawmakers have concerns as well. 

Protecting patients from getting massive bills when they go to the emergency room and one of the doctors is outside their insurance network is seen as a rare area of bipartisan action this year. But the effort has been slowed by an array of competing proposals and intense lobbying from doctors and hospitals, who worry it would lead to damaging cuts to their payments.

Shalala said that she instead supports a rival proposal, more favorable to doctors and hospitals, that House Ways and Means Committee Chairman Richard Neal (D-Mass.) and ranking member Kevin Brady (R-Texas) also unveiled on Friday.

Shalala said she will seek to amend the bill next week but hasn’t worked out the details of her amendment given that she was only just shown the legislation. 

“I have problems with it because it’s not balanced,” Shalala said of the Education and Labor proposal. “What I mean by that is the insurance companies are the big winners, the hospitals in my district and their employees get hurt and they’re the largest employers in my district. I can’t support a bill that will hurt the hospital workers in my district.”

Asked to respond, a spokesperson for Scott said, “There is broad consensus around the approach the Committee proposed today both within the Committee, as well as with our colleagues in the House Energy and Commerce Committee, and Senate [Health, Education, Labor and Pensions] Committee.”

The main dispute is over how much the insurer will pay the doctor or hospital once the patient is taken out of the middle. 

The Energy and Commerce and Education and Labor bills would both set the payment rate based on the median payment for that service in the geographic area, with the option of going to arbitration for some high-cost bills. 

In contrast, the Ways and Means bill gives the decision on payment to an outside arbiter, an approach more favored by doctors and hospitals but that has drawn criticism from the AFL-CIO and the consumer group Families USA as doing less to lower health care costs. 

Neal defended his bill on Friday by pointing to the importance of not angering hospitals. “We think that it’s a good foundation,” Neal said. “We think that it’s patients first. Everybody’s got big hospitals [in their districts].”

House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.) said Friday he thinks he can work with Ways and Means, but wants to make sure the final bill saves taxpayers money and does not raise premiums.