Sens. Lamar Alexander, a Tennessee Republican, and Patty Murray, a Democrat from Washington, on Thursday released a draft of bipartisan measures on surprise billing, drug costs, price transparency and other issues. The effort comes after the duo held multiple hearings on health care in the last session.
The goal is to get legislation on President Donald Trump's desk in July, though his willingness to collaborate with Democrats was thrown into doubt Wednesday after he refused to work with the party on infrastructure until it stops investigating him in the House.
Lawmakers in both chambers have shown a willingness to work together on some health care issues that are plaguing Americans. Bipartisan efforts on surprise billing and drug prices have been released in recent weeks, and the House recently voted overwhelmingly to take two small steps to make generic drugs more available.
But the two parties continue to lock horns in the House on larger measures, such as Medicare for All and strengthening the Affordable Care Act. House Republicans largely voted against a package last week that contained bipartisan bills to make it easier for generic drugs to come to market because it also had language intended to reverse Trump's efforts to chip away at Obamacare.
What's in the new proposal
The Alexander-Murray discussion draft on surprise billing has elements of legislation introduced in the House and Senate last week. Patients who need out-of-network emergency care would only be responsible for their in-network costs and those who need follow up services would have to be told in advance if any providers don't participate in their insurance plan.
It provides several options for settling the remainder of the bill, including allowing the insurer and provider to enter arbitration, guaranteeing that every practitioner in the in-network facility also be considered in-network or having the insurer pay the median rate for the service in the area.
The draft would also aim to speed the introduction of lower-priced generic drugs and drugs known as "biosimilars," which are less expensive versions of costly and complex biologic medications. And it would help patients learn more about and seek lower-cost care through wide-ranging efforts such as banning gag clauses between providers and insurers that hide cost and quality information and requiring them to provide consumers with estimated out-of-pocket costs for specific services.
It would also mandate that insurers keep their directories of in-network providers up-to-date and that providers send bills within 30 business days or patients aren't required to pay.
Medicare for All debate continues
The draft comes a day after the House Budget Committee held a hearing on establishing a government-run, single-payer heath insurance system in the US -- such as Medicare for All.
Lawmakers pelted experts from the Congressional Budget Office, which released a report last month on complex issues Congress would have to consider when designing such a plan, including how it would be financed, how much providers would be reimbursed and how much patients would have to pay out of pocket. Outside estimates have put the tab at $32 trillion over 10 years, and industry groups representing insurers, doctors, hospitals and drug makers have already joined forces to oppose any legislation.
Lawmakers at the hearing, which did not directly examine the Medicare for All bill introduced earlier this year by Washington Democratic Rep. Pramila Jayapal, largely sought to strike political points.
Republicans repeatedly attacked such a system for being costly, stripping Americans of choice and leading to longer waits for care. Democrats, meanwhile, focused on the need to expand health care to the estimated 30 million people currently uninsured and on the ability for a government-run plan to lower administrative costs and strike better deals with providers.
House Democratic leaders have not embraced Medicare for All, and it's unclear how far it will advance. But Budget Committee Chairman John Yarmuth, a Kentucky Democrat, struck a positive note.
"It is incumbent upon us to begin to work through the opportunities and tradeoffs involved in a single-payer system, as well as other ways to achieve universal coverage, many of which have been proposed by members of this committee," he said. "I strongly believe it's not a matter of if we will have universal coverage, but when. The CBO report and this hearing are designed to advance that timeline."
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