House panel advances bipartisan surprise billing legislation despite divisions

The House Education and Labor Committee on Tuesday approved a bill to protect patients from massive “surprise” medical bills, but not before a vigorous debate that showed the divides within both parties on the issue. 

The vote of 32-13 sent the measure to the full House. But competing proposals must be reconciled before the chamber can vote on the issue, which is a rare area of possible bipartisan action this year. 

In a sign of the unusual divisions on the issue, both committee Chairman Bobby Scott (D-Va.) and the top Republican on the panel, Rep. Virginia Foxx (R-N.C.), supported the bill, which would protect patients from getting bills for thousands of dollars when they go to the emergency room and one of their doctors happens to be outside their insurance network. 

“This bill reflects a genuine compromise,” Scott said. “This approach is bipartisan and bicameral.”

But a bipartisan group of lawmakers opposed the measure, instead supporting a rival bill from the House Ways and Means Committee that is more favorable to doctors and hospitals, who have lobbied hard against the Education and Labor approach, worrying they would see damaging cuts to their payments under it. 

Reps. Donna Shalala (D-Fla.), Joe Morelle (D-N.Y.), Phil Roe (R-Tenn.) and Kim Schrier (D-Wash.) were among the lawmakers to rebel against the Education and Labor legislation. Roe and Schrier are doctors themselves and warned about its effects on doctors.  

Shalala called the bill “government rate-setting in the private sector,” and a “ham-handed attempt to bend the cost curve.”

Roe said the bill is not “consistent with the American spirit” because it had too much government intervention. 

The dispute comes down how much the insurer will pay the doctor once the patient is taken out of the middle. 

The Education and Labor approach, which is also backed by the House Energy and Commerce Committee and the Senate Health Committee, would set the payment rate based on the median amount paid for that service in the geographic area, with the option of going to arbitration for some higher-cost bills. 

The rival Ways and Means approach, which is backed by doctor and hospital groups, would instead give the payment decisions to an outside arbiter. 

Unions and consumer group have backed the first approach, warning that the Ways and Means approach risks driving up health-care costs that would be passed on to consumers in the form of higher premiums. The White House also warned against the Ways and Means approach on Tuesday. 

“Arbitration just adds in another layer of administrative cost to our health care system,” said Rep. Pramila Jayapal (D-Wash.), the co-chairwoman of the Congressional Progressive Caucus and a supporter of the Education and Labor bill. “We want the biggest savings for patients.”