Californians to Benefit from COVID-19 Relief and Solution to Surprise Medical Bills

Health advocates expressed support for the package of COVID-19 financial relief set for a vote in Congress today, with the vow to continue to advocate for key elements that are not included in the current package, such as state and local aid to maintain health and other vital services. In particular, health advocates are pleased with the inclusion of consumer protections to stop surprise medical bills, a long-sought solution to ensure patients don’t get unexpected out-of-network bills from health providers, which can often be in the hundreds or thousands of dollars. 
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For Immediate Release: Monday, December 21, 2020

CONTACT:
Anthony Wright, executive director, Health Access California, awright@health-access.org, 916-870-4782 (cell)
Rachel Linn Gish, director of communications, Health Access California, rlinngish@health-access.org, 916-532-2128 (cell)

CALIFORNIANS TO BENEFIT FROM COVID-19 RELIEF AND SOLUTION TO SURPRISE MEDICAL BILLS

  • While much more is needed, the Congressional COVID-19 package includes direct help to California families, and funding for vaccine distribution. 
  • The federal proposal also protects patients and stops surprise medical bills from doctors, hospitals, emergency rooms, and air ambulances.
  • The new national fix–years in negotiation–would keep in place California’s four year-old landmark law against surprise medical bills from out-of-network physicians, AB 72. Health Access’  2019 report  described the positive impacts of that state law, which goes further than the federal deal in preventing inflated health prices.  
  • Federal fix fills in gap to stop surprise medical bills, especially for emergency rooms and air ambulances, and additionally for around seven million Californians currently in health plans that have been exempt from existing state patient protections.

SACRAMENTO, CA – Health advocates expressed support for the package of COVID-19 financial relief set for a vote in Congress today, with the vow to continue to advocate for key elements that are not included in the current package, such as state and local aid to maintain health and other vital services. In particular, health advocates are pleased with the inclusion of consumer protections to stop surprise medical bills, a long-sought solution to ensure patients don’t get unexpected out-of-network bills from health providers, which can often be in the hundreds or thousands of dollars.

“While the omission of key priorities like state aid will need to be revisited, this federal deal offers urgent relief crucial in this public health & economic crisis, from direct financial help for families to protection for patients against surprise medical bills. We will continue to advocate in the new year for the funds needed so state and local governments maintain health and other vital services, and affordability assistance for Californians to get and stay covered,” said Anthony Wright, executive director, Health Access California, the statewide health care consumer advocacy coalition. “In particular, money for vaccine distribution is especially important to ensure an efficient & equitable distribution that will help us get out of this COVID-19 crisis as quickly as possible. Public health professionals have been pleading for help, so we are not just jerryrigging the vaccine distribution on top of the fragmented financing of our patchwork health system. Investing in a smart and sensible coordination of vaccination will have big returns in getting our society and economy back sooner.”

ON SURPRISE MEDICAL BILLS: “We are relieved that the federal package finally includes a solution to surprise medical bills, protecting patients from getting stuck with a life-altering bill because their medical provider was unexpectedly out-of-network. This deal keeps California’s strong state solutions regarding physician surprise bills in place, while filling in key gaps, especially around emergency room bills and air ambulances, and for the 7 million Californians in health plans exempt from state patient protections who have been at risk of getting these bills,” said Yasmin Peled, policy advocate with Health Access California.

“While this federal fix to surprise medical bills was not our preferred solution, it still does the job to prevent patients from getting billed by these out-of-network doctors, ERs, and air ambulances, and including key protections against providers’ inflated charges. During this pandemic and after, patients will have the security of not getting a surprise medical bill when they do the right thing and seek needed care in-network but find out that their provider was unknowingly out-of-network.”

report released last year by Health Access showed the success of California’s compromise solution to stop surprise medical bills (AB 72). The report demonstrates how the three year old law has been successful in protecting patients from surprise bills which occur when patients go to an in-network hospital or facility but then get a bill from an out-of-network doctor. These bills come as a surprise to the consumer who did the right thing by going to an in-network facility or who sought emergency treatment, and can often be hundreds or thousands of dollars or more. While the report highlights the success in stopping surprise medical bills, many Californians needed a federal solution. In California alone there are six million people who do not fall under the protections of AB 72 because they are in federally regulated health care plans. Another million Californians are in plans regulated at the state Department of Insurance (CDI) and while they have protections against physician balance billing, they did not have the same protections against emergency room bills.

In addition to actively working on a federal fix, Health Access California had been working in the California Legislature over the past two years to pass AB 1611 (Chiu), to fill these gaps in state patient protections, but those efforts stalled in Senate Health Committee. The federal legislation resolves these issues, and also commissions a study on ground ambulance services, a remaining source of surprise medical bills.

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