During a rambling 45-minute speech that veered into matters of foreign policy and his anger over the special counsel’s report, Trump pushed for a measure that he said would be bipartisan, even as House Democrats — some of whom the president also attacked by name — took up legislation to fortify and improve the Affordable Care Act.
“We are determined to end surprise medical billing,” Trump said of the practice, which occurs when a doctor is unexpectedly not part of an insurance network. “We are going to hold insurance companies and hospitals totally accountable.”
The move to streamline billing costs amounts to a piecemeal effort by the president, who describes the Republican Party as the party of health care even though, in April, he decided to punt on providing a Republican answer to the Affordable Care Act. Trump backed off plans to introduce a Republican replacement for the law after Sen. Mitch McConnell, the majority leader, privately warned him that the Senate would not revisit health care in a comprehensive way before the 2020 elections.
Trump said he expected lawmakers to deliver legislation to him shortly, and said his administration would be releasing within weeks more details on how it would be making drug prices more transparent.
In a call with reporters Thursday, Joe Grogan, the director of the White House Domestic Policy Council, said the administration would press to have lawmakers find a way to protect people with insurance from encountering out-of-network bills after their emergency room visits, and would make them accountable for the amount they would pay if the service received was inside of their coverage network.
Administration officials also said any legislation should protect people who schedule medical services in-network only to be billed later by an out-of-network provider — such as an anesthesiologist or radiologist.
As Trump praised his administration’s effort to work with Democrats to provide greater transparency in the billing process, he attacked individual Democrats as he rolled out his initiative.
He insulted Rep. Jerrold Nadler, D-N.Y., chairman of the House Judiciary Committee, saying, “I beat him all the time.” He accused Democrats of trying to “redo” a special counsel report that had vindicated him.
Nevertheless, the president was joined Thursday by a bipartisan group of lawmakers, including Sens. Bill Cassidy, R-La., and Maggie Hassan, D-N.H. Sen. Lamar Alexander, R-Tenn., told Trump that he could expect to see legislation by July.
In the House, Rep. Frank Pallone Jr., D-N.J., chairman of the Energy and Commerce Committee, released a joint statement with his Republican counterpart, Rep. Greg Walden of Oregon, expressing their interest in collaborating on the issue. At the same time, House Democrats are preparing to introduce a bill that would target a Trump administration rule that expanded the use of short-term health care plans that provide cheap, limited coverage.
The issue is consistently popular with voters. A poll last year by the Kaiser Family Foundation found that 67% of Americans worry about unexpected medical bills, with 38% saying they were “very worried” about them. As House Democrats sought to protect the Affordable Care Act and attack Trump’s medical initiatives, the president said the billing initiative he announced on Thursday could be a “better” solution than a health care law.
A senior administration official who spoke on the condition of anonymity later told reporters that the president had been inspired to act after participating in a round-table in January and hearing from people who were affected by the billing practices.
A bill meant to help medical patients will most likely set up a battle with insurance companies, hospitals and doctors, stakeholders that will be looking to avoid shouldering the burden if consumers end up seeing relief.
Nationwide, more than 1 in 5 visits to an in-network emergency room result in an out-of-network doctor’s bill, studies have found. Yale research released by the National Bureau of Economic Research in 2017 determined that a select group of ER doctors at particular hospitals were responsible for much of the surprise billing.
At about 15% of the hospitals, out-of-network rates were over 80%, the study found, a figure administration officials cited Thursday.
“You have to come up with a solution,” Grogan said in March, “or bad things could happen because you’ll have policymaking being made by people that don’t understand the system nearly as well as you.”
This article originally appeared in The New York Times.