TexPIRG backs bill to lower health care costs

On December 8th, TexPIRG joined with the Texas Employers for Affordable Health Care in sending letters to the Texas congressional delegation, urging them to support and pass the Lower Costs, More Transparency Act (HR 5378).

The bipartisan bill would take a first step in lowering health care costs by strengthening current agency requirements for hospital price transparency, expanding price transparency to other providers, improving transparency from health insurance carriers, ordering reports on federal price transparency tools, requiring site-neutral payments for certain Medicare services so patients get the same treatment for the same price regardless of the setting, and separating billing codes for hospitals and off-campus outpatient departments so service locations are better identified and appropriate payment rates are applied. These are important provisions that work to address two key issues that contribute to the high and rising costs of healthcare: a lack of transparency and increasing market consolidation.

Rising health care costs, a lack of price transparency, and unfair billing practices burden patients and their families across the country. When patients don’t know the price of their health care, they can’t plan for these expenses, which puts them at risk of huge medical bills. These unexpected costs could lead to debt and other financial consequences, as well as decision-making that could put their health at risk. Nearly 90% of voters nationwide agree that Congress should take action to reduce hospital prices. Putting prices in the hands of patients is one important tool to fully understand their medical expenses. 

In Texas, 87% of voters are concerned about the effects of health care consolidation. When hospitals and health systems purchase primary care providers, clinics, and other doctor’s offices, payers like Medicare can’t tell where services are being provided, allowing hospitals to charge higher reimbursement rates at these non-hospital locations. Patients also end up paying higher co-pays and coinsurance for treatment in non-hospital locations simply because their clinic or provider office is now owned by a hospital system. Insurance plans also pay more, which can be passed on to Texans in higher premiums in the following year. These higher prices and unfair billing practices stem from a change in ownership and consolidation, rather than any change to the services being provided or the cost of care. If the Lower Cost, More Transparency Act is passed, these unfair billing practices based on “ownership” can be prevented and thereby lower costs for both patients and our insurers. 

Prices should be accessible and easily comparable so patients are prepared for any financial burden health care may impose, and unfair billing practices must be stamped out.