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Arbitration Amendment Will Put Patients In Harm’s Way

posted by AHIP

on July 17, 2019

WASHINGTON, D.C. – Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP), issued this statement following the arbitration amendment that will be offered to the bipartisan Energy & Commerce legislation to address surprise medical bills (H.R. 3630):

“No patient should receive a surprise medical bill from a doctor they did not choose – or didn’t even know treated them in the first place. Unfortunately, this amendment takes a significant step backward.  It protects the profits of a small but politically influential group of providers, not patients.

“We strongly oppose the inclusion of arbitration because it does not solve the problem of surprise medical bills. It increases the financial burden on everyone with coverage, increasing patient premiums and driving up the cost of health care. The arbitration proposal allows private-equity firms and certain providers to price gouge patients and then shifts the final decision to a “third party”. This process introduces new bureaucracy and red tape into the system, with costs to hardworking taxpayers exceeding $1 billion.

“Independent experts, employers, health insurance providers, consumer groups, labor unions, and patient groups agree: arbitration is not the solution.  Only one group wants arbitration: specialty doctors and the private equity firms with a stake in their financial success.  Not because it’s the right approach or about patient care, but because it’s better for their bottom line.

“The only solution to protect patients – according to most Republicans and Democrats and industry experts alike – is to establish a fair, competitive benchmark based on locally negotiated rates between doctors and health insurance providers, with no need for arbitration.

“Today, too many American families are struggling to pay an unexpected medical bill. We urge Congress to reject this amendment and focus on real solutions that will protect patients from surprise medical bills, establish rates negotiated by the free market, preserve plan networks that deliver high quality care, and bring down health care costs for every American.”