The purpose of health insurance is to help pay for medical care, yet health insurance is increasingly costing Americans more but covering less.
In a new Morning Consult poll, 59 percent of Americans said they wish their insurance company provided plans with lower deductibles so they could better afford the health care they need. According to a Kaiser Family Foundation study, over the last 12 years deductibles in job-based health plans have nearly quadrupled. Such high deductible plans can lead to surprise medical bills for patients who suffer an emergency before they’ve reached their deductible, regardless of whether the care was in- or out-of-network.
Congress is currently debating who should cover the costs of surprise medical bills. While 81 percent of Americans believe the majority of costs associated with surprise medical bills are the responsibility of insurance providers, this is unfortunately not the experience for many patients. Despite the fact that patients cannot, and should not, shop for medical treatment in the case of emergencies, right now if a patient is treated by an out-of-network provider, the insurance company is under no obligation to pay for the medical services provided, and the patient is stuck with the bill.
Americans pay for insurance with the belief that it should protect them from financial harm in the case of medical emergencies. Patients requiring such medical treatment should not be under an obligation to first check their insurance status, they should immediately receive the treatment they need.
Congress is currently considering two solutions to surprise medical bills: capping rates for out-of-network providers or implementing an independent dispute resolution (IDR) process. When given a choice, 69 percent of Americans prefer a third-party resolution process over allowing the government to set doctors’ rates. IDR protects the patient while effectively incentivizing providers to charge reasonable rates and insurers to pay appropriate amounts from the start.
IDR would also take into account the increased costs associated with rural health care and ensure rural Americans’ access to health services continue to be protected. Sixty-three percent of Americans are concerned about the effect government rate-setting would have on small communities already facing hospital and doctor shortages, and 67 percent of Americans agree Congress must protect access to health care for millions in rural communities.
The answer is clear: Americans want Congress to establish an independent dispute resolution process that would protect everyone's right to high-quality medical treatment and bring insurance companies and providers to the table for fair and fast billing dispute resolution rather than sticking them with the bill.