We’re standing together to put an end to surprise medical bills

We’re standing together to put an end to surprise medical bills

Last year’s biggest legislative battle on healthcare to return

by Rachel Warino

“When Sarah had a baby in June 2015, she researched her options and chose an in-network hospital. She ended up having an unplanned C-section and was surprised when she received a $1,050 bill for the out-of-network anesthesiologist. “I'm grateful that my baby girl is healthy and that my delivery went well, but I had no idea the anesthesiologist would be out-of-network and not covered by my insurance. That unexpected additional $1,050 bill was a burden on our budget”

What happened to Sarah is not an isolated incident. The unfortunate reality is that it’s a scenario all too common for far too many Californians. Folks think they are playing by all the rules when seeking out healthcare, yet find themselves saddled with hefty invoices that show up on their doorstep without warning.  Efforts to address this growing problem in the last legislative cycle unfortunately didn’t succeed as the legislature failed to act. Californians continue to receive surprise medical bills from out-of-network providers after using in-network medical facilities.

To address this, the California Labor Federation is now a co-sponsor of AB 533 (Bonta), a critical bill to stop surprise billing. The Federation joins Health Access, a statewide health care consumer advocacy coalition, the Consumers’ Union and other consumer and worker advocates to close a health care loophole that’s driving up costs and hurting patients.  AB 533 offers commonsense protections for consumers and is supported by patients, insurers, labor unions and businesses throughout California.

During the launch yesterday, Anthony Wright Executive Director of Health Access further detailed the issue of surprise billing:

These bills could come from an out-of-network anesthesiologist, pathologist, radiologist or another health professional that the patient may have never met and did not choose, costing them hundreds or thousands of dollars.

Typically, consumers are unaware if they encountered an out-of-network provider until they receive the surprise bill, which can be hundreds or thousands of dollars and cause financial hardship for consumers. Further, these bills do not count toward the annual in-network cost-sharing cap of $6,600.

Steve Smith of the California Labor Federation added:

It’s this type of gaming of the system that’s driving health costs higher for both workers and employers. Every extra dollar that goes to pay for health coverage is a dollar that comes directly out of workers’ pockets. We simply can’t sustain double-digit increases to our insurance premiums because it’s eating away at gains workers should be seeing in their paychecks.

AB 533 protects workers from exorbitant surprise bills for medical procedures that they thought were covered. It sets a fair and reasonable payment standard for doctors to prevent premiums from increasing. This is common sense. If you go to an in-network provider for a procedure that you rightfully believe is covered, you shouldn’t get a surprise bill in the mail demanding thousands of dollars from a doctor you may have never even met.

The legislature has the opportunity to do the right thing by protecting workers and consumers alike while chipping away at rising health costs. As a sponsor of AB 533, the Labor Federation considers this bill a priority. We look forwarding to working with the legislature to pass this important measure.

You can read more stories from workers who have been affected by surprise bills here and learn more about AB 533 via this Fact Sheet here