President Trump on Ending Surprise Medical Billing
Washington, DC: The White House reports 5.9.2019 –
THE PRESIDENT: Hello, everybody. Yesterday, Secretary Azar announced a bold, new initiative to require drug makers to disclose the prices to consumers. And it’s going to be something, I think, very special. You may have heard about it; maybe not. But it’s the beginning of a plan of transparency. And I think it will have quite an impact. So, thank you very much. That was a job well done. Everybody said it. (Applause.)
Thank you all for being here as we address one of the biggest concerns Americans have about healthcare. The Republican Party — I have to say this — is, really, very much becoming the party of healthcare. You see what we’re doing. We’re determined to end surprise medical billing for American patients. And that’s happening right now.
I want to thank Secretary Acosta, Secretary Azar, and everybody else in the room for joining us. Some people with some incredible stories.
Thanks also to Senators Lamar Alexander, Maggie Hassan, Bill Cassidy, John Barrasso, and Representatives Kevin Brady, Devin Nunes, and Greg Walden. Thank you all very much. Thank you. (Applause.)
My administration has already taken decisive action to make healthcare more affordable for American families. We’ve vastly expanded lower-cost health insurance plans. That’s happening. And it’s been an incredible success.
We’ve begun a bold initiative to reduce the price of prescription drugs. And last year, drug prices saw their first decline in 46 years. First time in 46 years that drug prices have gone down. And now they’re going to be going down a long way further, including the fact that we may allow states to buy drugs in other countries if we can buy them for a lesser price — substantially less price. And that’s going to be very unique.
But we’ll allow them to go to other countries, because the drug companies have treated us very, very unfairly. And the rules and restrictions within our country have been absolutely atrocious. So we will allow them, with certain permissions, to go to other countries if they can buy them for 40, 50, 60 percent less. It’s pretty pathetic, but that’s the way it works.
For many years, drug companies gave foreign countries better deals than they gave our own country. Now we’re making sure that our great seniors share in the discounts given to other countries. And we will always protect patients with preexisting conditions, very importantly. The Republican Party will always protect patients with preexisting conditions. That’s the man right there.
In my State of the Union address, I asked Congress to pass legislation to protect American patients. For too long, surprise billings — which has been a tremendous problem in this country — has left some patients with thousands of dollars of unexpected and unjustified charges for services they did not know anything about and, sometimes, services they did not have any information on. They weren’t told by the doctor. They weren’t told by the hospitals in the areas they were going to. And they get, what we call, a “surprise bill.” Not a pleasant surprise; a very unpleasant surprise.
So this must end. We’re going to hold insurance companies and hospitals totally accountable.
And we’re joined today by families who have personally experienced some horrible injustices of surprise medical bills. Drew and Erin Calver from Austin, Texas. Drew, I’d like you to maybe come up, and Erin, to share your story. It’s a pretty amazing story.
MR. CALVER: Hi. I have insurance but was still stuck with a highly inflated medical bill. A lot of pain, stress, and fear with that bill looming over us. A highly inflated bill that I shouldn’t have to deal with.
And we hope that — we support the President that he’ll take it — the President’s call to Congress to take action and support, pass, end surprise billing, and also create more transparency in terms of medical bills. Thank you.
THE PRESIDENT: Would you like to explain what happened in your billing? Because it was sort of an incredible story.
MR. CALVER: Yeah. I had a heart attack two years ago and was driven to the nearest hospital. And although I had insurance, I was still billed $110,000.
The hospital threatened to send my bill to collections. And so, from there, all that stress and the fact that it was highly inflated, I was in shock when I found out some of the real prices of stuff I was charged for.
So I feel like I was exploited at my most vulnerable time in my life, just having suffered a heart attack. And so I hope that Congress hears his call to take action, close the loophole, end surprise billing, and just work towards transparency for the bills.
THE PRESIDENT: You look very good now.
MR. CALVER: Oh, thank you. (Laughter and applause.) (Inaudible.)
THE PRESIDENT: So, when you got that second bill, you handled it, right?
MR. CALVER: Yeah.
THE PRESIDENT: The heart was okay. (Laughter.)
MR. CALVER: Yeah, luckily I made it through. (Inaudible.) Yeah.
MS. CALVER: Yeah. And we paid it.
THE PRESIDENT: Good. You don’t want to run for President, that I can tell you. (Laughter.) You think that’s bad. (Laughter.) But it is bad, and it’s a shame.
Also here with us today are Dr. Paul Davis and his daughter Liz from Findlay, Ohio. Dr. Davis and Liz would like to tell you about their story.
Hi, Doctor, how are you? Thank you. Please.
DR. DAVIS: Mr. President and honored guests, it’s an honor for me to speak to you today. My family, like so many others, was victimized by a surprise medical bill.
My daughter, Elizabeth, was charged $17,850 for a urine drug screening. If anyone is interested, I have the bill; you may see it.
She had successful back surgery in Houston, Texas. And, at a post-op visit, because she had been given a prescription for a narcotic pain reliever that she used appropriately and as directed, he just said, “Oh, by the way, I would like to get a urine specimen.” “Fine.” She did it. A year later, the bill showed up for $17,850.
This type of — you know, this test, at best, is worth $100. It’s — actually, you can get it for $10 or $20. And this type of billing is all too common not just among dishonest providers. The problem of improper medical billing affects most those who can afford it least.
We must put aside any other differences we have and work together to solve this problem. I am very pleased to see this issue being brought to the nation’s attention. And I thank you.
THE PRESIDENT: Thank you, Doctor. I see it. It’s — I sort of wanted to check it myself. (Laughter.) It’s almost not believable. You look believable, but look at — (laughter) — but he’s right: $17,850 for a urine test.
DR. DAVIS: The EOB says that they would have paid, if it was in network, $100.92.
DR. DAVIS: And that’s still an inflated price.
THE PRESIDENT: So $100, and you paid $17,000.
DR. DAVIS: We settled for less, but I won’t go how much less, but it’s a bizarre story. I’d love to tell you, but I was told to keep it short.
THE PRESIDENT: Well, it says it right here. (Laughter.) That’s terrible.
DR. DAVIS: Thank you, sir. Appreciate this opportunity. (Applause.)
THE PRESIDENT: It’s a pretty amazing story. I’m glad I got to see that bill. I don’t know. You’re a very believable looking guy. What do you think, Lamar? I think — I think he had — check it out. Lamar, check that out, please. (Laughter.) That’s pretty incredible.
But there are many stories like that. I’ve heard them for years, myself — friends, where they just come back and they get a bill that they can’t understand it.
And we’re going to be announcing something, I think over the next two weeks, that’s going to bring transparency to all of it. And I think, in a way, it’s going to be as important as a healthcare bill. It’s going to be something really special. And we’re doing a great healthcare bill, if we get the Republican votes during the election, 2020.
But this could be something that will have a tremendous impact. Maybe a bigger impact than even a very good healthcare bill. Maybe even a bigger impact than when we took away the individual mandate from Obamacare. That was a big deal.
But the numbers you’re talking about through transparency are tremendous. It’s the new thing. And we’re going to be announcing it, I think, over the next two weeks. And it’s going to be very comprehensive.
We’re also joined by Dr. Martin McKary, a top surgeon at Johns Hopkins University — that’s a good place — who has studied this issue closely. Dr. McKary, please come up. Thank you.
Hi, Doctor. How are you?
DR. MCKARY: Great. Thank you.
Mr. President, thank you for listening to the real healthcare experts, who are the patients and the doctors, not just the special interests. So thank you.
When someone buys a car, they don’t pay for the steering wheel separately from the spark plugs and the conveyer belt. But yet, in healthcare, surprise bills and overpriced bills are now commonplace and they’re crushing everyday folks like these patients.
People are getting hammered right now. When hospitals were built, they were built with a charter specifying — most of them — that they would be a safe haven or a place of refuge for the sick and injured regardless, according to their charter — regardless of race, ethnicity, or one’s ability to pay.
Yet, today, surprise bills are hammering everyday Americans. They’ve done nothing wrong. They work and have a job and they have insurance, and they’re getting hammered.
In my own profession of surgical oncology, we see now that half of women with stage-four breast cancer report being harassed by medical bills. That’s a disgrace to my specialty. That’s a disgrace to the medical profession. And that’s a disgrace to our country. We can do better.
Hospitals and healthcare can get their act together to provide one honest and fair transparent bill so we can restore medicine to its mission and finally stop the erosion of the public trust that we’re seeing.
Thank you, Mr. President. (Applause.)
THE PRESIDENT: Thank you very much, Doctor. Thank you, Doctor. Thank you very much.
And I’ll go a step further: No American mom or dad should lay awake at night worrying about the hidden fees or shocking unexpected medical bills to come.
Today I’m announcing principles that should guide Congress in developing bipartisan legislation to end surprise medical billing. And these senators and congressmen and women that are with us today are really leading the charge. And I appreciate that they’re all here. Thank you all. Thank you all for being here. This is fantastic.
And I think it’s going to be a successful charge. From what I understand, we have bipartisan support, which is rather shocking. That means it’s very important. That means it’s very good. But that’s great.
First, in emergency care situations, patients should never have to bear the burden of out-of-network costs they didn’t agree to pay. So-called balance billing should be prohibited for emergency care. Pretty simple.
Second, when patients receive scheduled, non-emergency care, they should be given a clear and honest bill upfront. That means they must be given prices for all services and out-of-pocket payments for which they will be responsible. This will not just protect Americans from surprise charges; it will empower them to choose the best option at the lowest possible price.
Third, patients should not receive surprise bills from out-of-network providers that they did not choose themselves. Very unfair.
Fourth, legislation should protect patients without increasing federal healthcare expenditures. Additionally, any legislation should lead to greater competition, more choice — very important — and more healthcare freedom. We want patients to be in charge and in total control.
And finally, in an effort to address surprise billing, what we do is, all kinds of health insurance — large groups, small group, individual markets, everything. We want everything included.
No one in America should be bankrupted and unexpectedly by healthcare costs that are absolutely out of control. No family should be blindsided by outrageous medical bills. And we’ve gone a long way to stop that.
I think next week we’ll go even further — possibly the week after. It’s being drawn now but it’s one of the strongest things we’ve done as an administration. And I don’t think any administration has done more. If we get this the way we want it, over the next two weeks, I think you’ll see something that’s going to be great.
Our initiative to end surprise medical billing is one of many steps we’re taking to fix our nation’s broken healthcare system and to deliver better care, with more choices, at lower costs.
My administration is eager to work with both parties in Congress to save American patients thousands and thousands and thousands of dollars, and to give American families greater peace of mind. They’re surprised with these bills. It’s ruined people’s lives. They leave a hospital with something they think is going to be routine and they end up in court, and they end up going to court. And then they end up with lawyers’ bills that are bigger than anything they could have imagined. They get it from every side. We’re not going to have that anymore.
So today, I ask Democrats and Republicans to come together, to work together. Democrats and Republicans can do this. And I really think it’s going to be something that will be acted on quickly.
John, what do you think, right?
SENATOR BARRASSO: I believe it. Yes, sir, Mr. President.
THE PRESIDENT: Lamar, right?
SENATOR ALEXANDER: Mr. President, we’ll be bringing you a bill, we believe, in July.
“The seen and unseen costs of healthcare are still taking an enormous toll on millions of American families.” President Donald J. Trump
LIFTING THE BURDEN OF SURPRISE BILLING: President Donald J. Trump is putting forward principles to address the problem of surprise billing in healthcare.
- American families deserve to be protected against the burden of costly, surprise bills when their loved ones receive medical care.
- A 2018 poll by the Kaiser Family Foundation found that 67 percent of Americans worry about unexpected medical bills, with 38 percent saying they are very worried.
- Patients are often hit with surprise bills after receiving emergency care from an out-of-network provider, when they could not choose their provider.
- Patients also often receive surprise bills at highly inflated prices after receiving care from an out-of-network provider they reasonably assumed was in their network.
- The Trump Administration believes that any effort to address the issue of surprise billing should be undertaken with these principles in mind:
- Patients receiving emergency care should not be forced to shoulder extra costs billed by a care provider but not covered by their insurer.
- Patients receiving scheduled care should have information about whether providers are in or out of their network and what costs they may face.
- Patients should not receive surprise bills from out-of-network providers they did not choose.
- Federal healthcare expenditures should not increase.
PROTECTING PATIENTS: President Trump wants to ensure patients are not taken advantage of and have the price information they need to make informed decisions.
- The Administration wants to ensure patients are not price gouged in emergency situations by out-of-network providers they could not choose.
- In emergency situations, balance billing for amounts above the in-network allowed amount should be prohibited.
- The Administration wants to bring transparency to the confusing and opaque pricing system patients face when scheduling care.
- Before scheduling their care, patients should be given information about whether the care providers are out of their network and what related costs that may bring.
COMMITTED TO LOWERING COSTS: Combating surprise billing will build on the numerous actions President Trump has taken to put patients in control and lower the costs they face.
- The Trump Administration expanded short-term, limited duration insurance plans, which can be far cheaper than exchange plans and better suited to peoples’ needs.
- The Administration expanded association health plans, making it more affordable for small businesses to provide health insurance to their employees.
- The President signed the elimination of the individual mandate penalty.
- The President launched a campaign to drive down drug prices, and recently finalized a historic new requirement that drug companies include prices in television advertisements.
- The Food and Drug Administration set new records for generic drug approvals in 2017 and 2018, saving Americans $26 billion in the first year and a half of the Trump Administration.