TPA Sends Coalition Letter to HHS to Abandon Attempts to Enact Price Controls on Patients and Doctors

The Taxpayers Protection Alliance (TPA) sent a coalition letter with 11 organizations urging HHS to abandon attempts to enact price controls on patients and doctors.

The full letter can be found below or online here. 

April 5, 2022

The Honorable Xavier Becerra
Secretary
Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Becerra:

We, the undersigned organizations representing millions of taxpayers and consumers across the nation, urge you to follow Congressional intent when implementing the No Surprises Act of 2020 by abandoning any attempt to enact price controls on patients and doctors. While our organizations have diverse views on the best way to address the underlying issue of surprise medical bills, we stand united against the Biden Administration’s attempts to enact government price controls that Congress rejected through ongoing rulemaking processes at the Departments of Health and Human Services, Labor, and Treasury.

Patients are often stuck on the hook for medical bills that come about through no fault of their own. Whether it is through an emergency room visit or other needed care, patients may unwillingly receive care from a doctor or physician outside their insurance coverage network. In that case, they will receive an exorbitant bill they had no reason to expect, nor any opportunity to avoid. In many cases, surprise medical bills can be financially devastating for families.

Recognizing this problem, Congress debated different approaches to addressing surprise medical bills in the 116th Congress. One proposal, supported by the insurance industry and organized labor unions, would have instituted rate-setting at the federal level by forcing health care providers to accept arbitrarily depressed payment rates that would have harmed patients by limiting access to care, especially in rural and underserved areas. Our organizations formed the Coalition Against Rate-Setting (CARS) to oppose this misguided scheme, known as a “benchmark” rate.

The second proposal, that was ultimately signed into law in December 2020 in the No Surprises Act, held patients harmless for surprise out-of-network bills and established an independent dispute resolution (IDR) system for insurers and providers to resolve billing disputes if they cannot agree on their own. While our organizations may have differing views on an IDR process, we recognize the purpose of it is to provide a level playing field for resolving payment disputes. We also believe that Congress’s choice to enact an IDR system was a clear rejection of direct price controls through a benchmark rate.

The law tasked the HHS, Labor, and Treasury with undertaking rulemakings to implement the law. Unfortunately, HHS’s rulemaking process has veered sharply from Congress’s intent – namely, a clear rejection of federal price controls. Specifically, HHS’s interim final rule (released on September 30, 2021) forces arbiters to give special preference to the

median in-network rate (“Qualifying Payment Amount”) for health care services, even though Congress clearly and deliberately intended in statute for the IDR process to weigh all factors evenly. As noted in a recent letter signed by 151 bipartisan members of Congress, “This approach is contrary to statute and could incentivize insurance companies to set artificially low payment rates, which would narrow provider networks and jeopardize patient access to care – the exact opposite of the goal of the law.”

We are encouraged that this attempt to enact price controls through HHS’s IFR was reprimanded by the U.S. District Court for the Eastern District of Texas on February 23, 2022. Instead of appealing this decision in court or replacing the IFR with a Final Rule which contains the invalidated presumption in favor of the Qualified Payment Amount, we urge the Biden Administration to embrace the opportunity to go back to the drawing board and abandon its deeply misguided IFR.

In conclusion, on behalf of the taxpayers and consumers we represent, we strongly urge you to abandon your flawed Interim Final Rule and draft a Final Rule that rejects all forms of federal price controls. We stand ready to act as a resource should you choose to draft a rule that protects patient and providers.

Sincerely,
Taxpayers Protection Alliance

Americans for Prosperity

Americans for Tax Reform

California Policy Center

Center for a Free Economy

Center for Freedom and Prosperity

Competitive Enterprise Institute

Consumer Action for a Strong Economy

Institute for Liberty

National Taxpayers Union

Rhode Island Center for Freedom and Prosperity

Rio Grande Foundation

CC:

Marty Walsh, Secretary, Department of Labor

Janet Yellen, Secretary, Department of Treasury