For the uninsured, seeking medical treatment almost always results in a costly medical bill. But, over the past few years, it's become clear that even if you have health insurance in the U.S., you're still susceptible to receive pricey medical bills—many of which can be a complete surprise.
For the insured, an expensive bill is expected when one visits an out-of-network physician. Lately, bills have been popping up in the least expected places. For these patients, charges roll in even though they did research and, presumably, went to an in-network hospital or saw in-network physicians.
President Obama’s 2017 budget for HHS takes action to eliminate these surprise bills.
Embedded within the 2017 budget is a provision to “eliminate surprise out-of-network healthcare charges for privately insured patients.” The administration would try to solve the problem by requiring physicians who “regularly provide services in hospitals” to accept in-network rates, even if they aren't in the insurer's network. Hospitals would also have to “take reasonable steps” to ensure patients see in-network physicians.
Usually, patients face unexpected charges because of large payment disagreements between insurance companies and physicians. Physicians will refuse to participate in an insurer's network if they believe arguing insurers are low-balling them. But, insurers say doctors ask for unreasonably high rates. Hospitals and patients are often left in the middle. Under President Obama's 2017 budget, patients would be removed from the disputes, and physicians would have to cave to the insurers' rates.
However, American Medical Association President Dr. Steven Stack said last year that he didn't like any approach that would “coerce physicians through yet another way to not receive sufficient payment,” indicated that the budget proposal won’t be popular with physicians.
President Obama's budget for 2017 stands pretty much no chance of moving through Congress, but it does reveal the president's final priorities for his own and future administrations.