PROTECTING GEORGIA’S CITIZENS
Two-thirds of insured Americans are worried about paying an unexpected out of network medical bill. And for good reason. In Georgia, 1 out of 6 patients have received a surprise bill for inpatient care and 1 out of 8 has received a surprise emergency bill, according to the Peterson-Kaiser Health System Tracker. At SVdP Georgia we see many working families who are already cost-burdened due to the high cost of housing. A surprise medical bill for them can be catastrophic, wipe out their limited savings, and push them over the financial edge.
This past year, we watched our state legislators agree that something has to be done but not be able to agree on how to do it, leaving Georgia’s citizens vulnerable. Now the same seems to be happening at the federal level with several competing bills making their way through committees. The one with the most promise to bring down health costs and eliminate surprise medical bills is sponsored by the chair and ranking member of the Health, Education, Labor and Pensions Committee, Sens. Lamar Alexander (R-Tenn) and Patty Murray (D-Wash). Their comprehensive bipartisan legislation targets 5 areas for reform.
- Ending Surprise Medical Bills: the bill requires all emergency care to be considered in-network, prohibits balance billing for more than the in-network amount, and uses the local median amount that insurers would pay as the benchmark for payment. Of particular interest to rural Georgians is that air-ambulances used to service patients in remote areas are also required to be in-network.
- Reducing the Prices of Prescription Drugs: the bill aims to reduce the cost of drugs by making it easier for generic drugs to get to market, and targeting PBMs (pharmacy benefit managers) who are often criticized for helping to maintain high drug prices by requiring that 100% of the rebates given to a PBM by a drug manufacturer go directly to the consumer.
- Improving Transparency in Healthcare: the bill bans gag clauses and other anti-competitive practices that limit consumer access to higher quality, lower cost care and requiring plans to maintain up to date directories of in-network providers.
- Improving Public Health: the bill mandates a campaign to educate people about vaccines and money to reduce vaccine-preventable diseases, authorizes the use of technology to increase health services in medically underserved areas, and grants to improve maternal health outcomes
- Improving the Exchange of Health Information: Requires health plans to provide consumers information about claims data, inpatient practitioners and expected out of pocket costs as well as measures to improve privacy and security of health data.
SVdP Georgia supports this commonsense, bipartisan, comprehensive legislation to lower healthcare costs and calls on our legislators to support it as well to protect the people of Georgia.