Trump promises executive action to prevent surprise medical bills

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One order would block discrimination against patients with preexisting conditions

President Trump says he will sign a series of executive orders aimed at preventing patients from getting hit with surprise medical bills.

Administration officials say part of that policy will be protections for people with preexisting conditions -- such as the protections provided under the Affordable Care Act (ACA) which the administration is seeking to dismantle.

Health and Human Services (HHS) Secretary Alex Azar, on a conference call with journalists, said one of the president’s orders would stipulate that people with preexisting conditions are covered by health insurance “regardless of whether the Affordable Care Act is unconstitutional and its protections for preexisting conditions invalidated.”

The Trump administration has joined or supported lawsuits seeking to overturn the ACA, one of the primary achievements of his predecessor, President Obama.

Action to block surprise bills

Azar said that the president’s decision to address surprise health care bills is important since it represents “a source of financial insecurity for all Americans who do have insurance that has gone unaddressed for two years now.”

The Trump order will reportedly direct government agencies to cooperate with Congress to pass a law protecting patients from medical bills that are much larger than they expect when they use out-of-network services. Unless something is passed by January 1, Azar said Trump will explore what unilateral action he can take that would accomplish the same thing.

A 2018 report and poll by West Health and Gallup found that out of 36 developed nations, the United States ranked highest in health care costs. In 2017, the most recent year for which data was available, Americans spent a total of $3.7 trillion on health care, or an average of $10,739 per person.

Big bills linked to health insurance

Studies have shown that surprise medical bills tend to be health insurance-related. A 2019 analysis by the Kaiser Family Foundation found that 18 percent of all emergency room visits and 16 percent of in-network hospital stays led to at least one out-of-network bill in 2017.

The likelihood of receiving an unexpected bill varied by state. In Texas, 27 percent of emergency room visits and 38 percent of in-network hospital stays generated at least one surprise charge. 

The financial impact on patients is hard to understate. A 2019 study published in the American Journal of Public Health found that more than 60 percent of consumers who have filed for bankruptcy said a medical bill “very much” or “somewhat” contributed to their financial plight

According to the study, 44 percent of American families had an unexpected medical expense the previous year. Of that figure, 40 percent surveyed said they didn’t have the money to deal with a $400 emergency.

The Supreme Court is scheduled to hear the latest challenge to the ACA in November, following the election.

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