As I sit here reviewing health plan choices for the coming year my mind thinks back to a number of billing issues my husband and I faced during his cancer treatments. Families like ours lived in a constant state of fear as to whether a procedure, treatment or test would be covered. At other times we worried about whether a particular provider would be covered or if the insurance company would deny coverage because the provider was deemed out-of-network — even though the hospital itself was in-network. These types of denials are known as surprise medical bills, and they are a plague impacting too many families.
Congress is considering a number of fixes to this problem, among them a “compromise” solution put forth by the insurance industry. There is no compromise involved as it would cover out-of-network providers at the median in-network rate. While this might seem good at first glance, the reality is it incentivizes reducing reimbursement rates to providers across the board and further increases obscene insurance industry profits. It would also have the effect of reducing access to care as an increasing number of doctors will be forced out of practice from insufficient compensation. Do we really want to reduce the number of doctors during a pandemic?
As patients we need coverage certainty and access to care. Providers need fair compensation to continue to practice. Congress must say no to the insurance industry’s “compromise” and not allow them to further profit at patients’ and providers’ expense.
Stacey Elin Rossi