Stopping Surprise Bills
What the Federal No Surprises Act Means for Californians
New Law Protects Millions of Californians from Surprise Medical Bills (Fact Sheet)
In a major victory, a new federal law going into effect January 1, 2022 will ensure over 6 million Californians will be protected from receiving certain surprise medical bills, which can wreak havoc on the finances of patients and their families. Surprise bills occur when patients get an out-of-network bill, either following emergency care or from an out of network doctor at an in-network hospital or facility. While California already has some of the strongest protections in the nation against surprise billing, the federal law fills in key gaps, most notably for those with coverage regulated at the federal level.
Key lessons learned from California from our fight for the landmark AB 72, outlined in this report, helped lead to federal action on surprise bills.
NEW:
- Health Access California Letter to CA Congressional Delegation on No Surprises Act (December 16, 2021)
- CA Coalition letter on No Surprises Act (December 6, 2021)
Battling Unfair Billing Practices and Overcharging
A hospital bill is often the biggest bill a person will get in her entire life, outside of a mortgage. Medical debt has been a factor in more than half of bankruptcies–for the uninsured and even among many insured who found out-of-pocket costs too overwhelming. While the Affordable Care Act extends coverage and puts limits on out-of-pocket costs, there is more to do to prevent unfair billing practices, from overcharging to aggressive collections practices.
Health Access supports efforts to strengthen consumer protections in the insurance market to prevent underinsurance and medical debt, going above and beyond the ACA as needed. For example, Health Access led efforts to pass California’s first-in-the-nation Hospital Fair Pricing Act, a 2006 law (authored by Assemblywoman Wilma Chan), which limits the common practice of charging uninsured and underinsured patients more for care than everybody else pays.
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Stopping Surprise Bills
- AB 2709 (2022): Banning Surprise Ambulance Bills
- AB 1611 (2019): Stopping Surprise ER Bills
- AB 72 (2016): Stopping Surprise Bills from Out-of-Network Facilities (key consumer protections and scope)
- UPDATED AB 72 Report: Patients Protected, Providers Paid: CA’s Experience to Stop Surprise Medical Bills (January 2022)
- AB533 Surprise Bills (Factsheet) (January 2016)
Preventing Medical Debt in CA
- Uninsured in the Emergency Room: New Patient Protections in Place; More To Do (April 2011)
- AB 1503 (Lieu): The Unnsured Pay More Than What’s Fair in the E.R. (August 2010)
- FACT SHEET: Protecting Consumers From Medical Debt (August 2009)
- Give Us a Sign: Hospital Overcharging Report (September 2004)
Resources for Advocates and Consumers
- hospitalbillhelp.org (website co-hosted by Health Access and Coalition Partners)
- Sample Hospital Bill Letter