No More Medical Debt: Closing Disparities in Hospital Billing

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To the Editor:

As a Hartford native, I’m invested in the well-being of my fellow community members. My mission is to elevate the voices of those in Hartford who are often left out of the decision-making table on matters that impact them, especially regarding health care. One longstanding barrier to accessing care – especially for historically marginalized communities and people of color – is the skyrocketing cost of health care services. Members of my community deserve to have their basic needs met through quality, timely medical care. But to fulfill this promise, we need better policy solutions to reduce out-of-control costs. 

Far too often, people are forced into debt because medical care has gotten so expensive. Medical debt is a significant concern in our state and country, forcing families to make budget cuts and pressuring people on fixed incomes. This is a devastating reality for millions of Americans. Our policymaking leaders need to zero in on the key drivers of high healthcare costs – like dishonest hospital billing practices – and eliminate them.

Unfair hospital billing is a pervasive issue that is allowed to run rampant across the country. This complicated issue – stemming from hospital mergers – is often swept under the rug. But more and more reports, like this one from Blue Health Intelligence, are finally bringing this issue to light.

Large hospital groups are buying up independent physicians’ practices – facilities that then become “hospital outpatient departments” (HOPDs). Then, when a patient visits this HOPD for their regular doctor’s appointment, they see a higher bill for the exact same services that were delivered at a more affordable price prior to the merger.

Connecticut lawmakers in Congress have an obligation to address this blatant dishonesty in hospital billing that is hamstringing patients. I’m encouraged to see that our state leaders have already taken the reins to confront this injustice, as Gov. Ned Lamont extended a provision this summer to address these hospital ‘facility fees.’ It prohibits any hospital or health system from collecting a higher facility fee on certain outpatient health care services. 

Our state is a trailblazer on this issue, but now, action must be taken on the federal level to solidify fair hospital billing for all. To do so, our federal lawmakers must support the Facilitating Accountability in Reimbursements Act (FAIR Act) in the House and the Site-based Invoicing and Transparency Enhancement Act (SITE Act) in the Senate.

These bipartisan, cost-saving pieces of legislation will directly address the longstanding disparities in hospital billing. The FAIR Act promotes fair hospital billing practices that will lay the groundwork for site-neutral payment reform proposed in the SITE Act. This means lower out-of-pocket costs for consumers and reduced national health costs upwards of $672 billion, including $150 billion in Medicare spending. I hope leaders like Congressman John Larson will be especially vocal in supporting the FAIR Act; Larson sits on the House Ways and Means Committee, which commonly examines Medicare-related policies.

We cannot wait any longer to deliver this relief to the American people. Health care professionals nationwide – from private practitioners to former ER doctors – are speaking out to say enough is enough. Connecticut’s own Dr. William Petit, a former state representative who was the ranking member of the Public Health Committee, spoke out on this very issue and highlighted why site-neutral payment reform is so critical.

Seeing the devastating effect high medical bills can have on our community members, I likewise felt compelled to shed light on this issue. We can all do our part to do more. I’m proud of the work my colleagues and I are doing at Health Equity Solutions in Connecticut to help people obtain optimal health care – regardless of race or socioeconomic background. I’m confident that we’re making a positive difference in patients’ experiences accessing health care. And with the help of meaningful policies like the FAIR and SITE Acts, we can make an even greater impact. Congress must pass these reforms now to ensure everyone, regardless of income or background, can access and afford the care they need.

Clarke, MSW, MPH is the Executive Director of Health Equity Solutions