For Immediate Release: Thursday, May 30, 2019
Rachel Linn Gish, director of communications, Health Access California, firstname.lastname@example.org, 916-532-2128 (cell)
LEGISLATION PROTECTING PATIENTS FROM SURPRISE EMERGENCY ROOM BILLS PASSES CA STATE ASSEMBLY
- AB 1611 by Assemblymember David Chiu and Senator Scott Wiener to stop surprise ER bills statewide passes off the Assembly floor after facing opposition from industry lobbyists.
- The bill ends “balance billing” in ERs by preventing surprise medical bills to patients beyond in-network cost-sharing and helps to prevent inflated premiums by setting a standard for reimbursement to the hospital, a key consumer protection.
- After high-profile stories and public pressure, Zuckerberg San Francisco General Hospital (ZSFG), reversed its position on sending surprise bills to insured patients. AB 1611 creates a statewide solution.
- AB 1611 now goes to the State Senate for policy hearings.
SACRAMENTO, CA – The California State Assembly today passed AB 1611 by Assemblymember David Chiu and Senator Scott Wiener to end surprise emergency room bills on a 48-9 vote. AB 1611 is a key patient protection that would also lower the costs of health care for California consumers. The bill faced opposition from industry lobbyists who argued that the status quo is working fine, but the patients who receive hospital ER bills of tens of thousands of dollars tell a different story. AB 1611 also gained an endorsement from the Los Angeles Times.
After an emergency room visit, some California patients still receive a “balance bill” which is the difference between what the hospital charged for the service and what the insurer paid for the service. These unexpected medical bills can be huge, even after the patient’s insurance pays their portion. When experiencing an emergency, Californians are not able to choose where they are taken for their care. AB 1611 prevents patients from being on the hook for a bill incurred when receiving care at an emergency room in a hospital that ends up being out of network.
“After a trip to the emergency room, the only thing you should be focused on is getting better, not a bill for tens of thousands of dollars,” said Assemblymember David Chiu (D-San Francisco), the author of AB 1611. “This legislation will protect patients from surprise emergency room bills and hopefully bring some peace of mind to those who need emergency care.”
For the majority of consumers, California law requires a health plan to cover the cost of the emergency care a patient receives whether or not a hospital is in-network. However, there is still a giant gap in state law. Specifically, six million Californians with federally regulated health plans and one million Californians with coverage regulated by the California Department of Insurance are at risk for surprise emergency room bills because they are not covered by these important consumer protections.
In 2017, California enacted and implemented strong protections against surprise billing for patients in health facilities with AB 72. AB 1611 closes remaining gaps in state law and extends important consumer protections for those that get care in emergency rooms.
The bill is already prompting change. After high-profile stories and public pressure earlier this year, Zuckerberg San Francisco General Hospital (ZSFG) announced a proposal to end their egregious practice of keeping their ER out-of-network in order to charge insured patients higher rates. But ZSFG is not alone – many other hospitals also engage in this practice. AB 1611 would prevent balance billing and surprise emergency bills statewide. The bill is co-sponsored by Health Access California and the California Labor Federation.
“Patients in an ambulance are in no position to choose what emergency room they end up at, and certainly should not get any extra or inflated charges if the hospital is out-of-network. AB 1611 is a key consumer protection that could help save Californians from crushing medical bills,” said Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition. “We comment the State Assembly for standing with California patients over industry lobbyists to pass this important bill. We implore our State Senators to do the same”
“Working people who go to the emergency room because of a sudden injury or illness shouldn’t have to also endure the shock of surprise ER bill to the tune of thousands of dollars,” said California Labor Federation Executive Secretary-Treasurer Art Pulaski. “We applaud the Assembly for protecting families by passing AB 1611 today. This bill is common-sense reform that protects workers and allows patients to focus on recovery instead of worrying about a surprise bill that threatens to bankrupt their family. We look forward to the Senate passing this important measure and the governor signing it into law.”
AB 1611 now moves to the State Senate for policy hearings in the coming weeks.