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Balance Billing, a.k.a. “Surprise Billing”

Bipartisanship is in the air in Washington, D.C. Well, at least on one issue that has frequently made the news over the past several years: surprise, or balance, billing. Driven by devastating stories in the popular press, a slew of proposals have been introduced in Congress over the past year. While diverse in their approaches, all of the proposals seek to increase consumer protections and shield patients from unexpected and often outsized bills. President Donald Trump has expressed his support for these efforts. Without a doubt, federal action on the issue is long overdue.

Yet, ultimate success seems far from certain, as jousting among competing stakeholders has replaced the usual partisan quarrels in D.C. Moreover, while surprise billing has unquestionably caused great individual harm, the current debate has largely missed two other important problems related to provider networks: inaccurate provider directories and inadequate provider networks. These problems are inherently complex, harder to turn into news stories, and defy simple solutions. Yet, they also affect a much larger number of Americans’ financial and physical well-being than does surprise billing.

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