WASHINGTON — Competition among providers has always been the best way to keep health care prices down. The Hospital Price Transparency Rule, which was implemented on January 1, 2021, by the Trump administration, requires hospitals to disclose charges, cash prices and prices negotiated with commercial insurance plans for all services. The Transparency in Coverage Rule, also implemented by the Trump administration, was effective during 2022 and 2023. It required disclosure by health plans of in-network negotiated rates with doctors and facilities, out-of-network rates, and net drug costs.
“Not surprisingly, hospital and health insurance lobbyists strongly opposed the demise of secret health care prices,” says Katy Talento, executive director of the Alliance of Health Care Sharing Ministries (Alliance.org).
In 2021, the No Surprises Act, enacted by Congress and signed by President Trump, added more clout to cost control. Among other things, that law was supposed to protect patients from surprise medical bills by:
1) Requiring private health plans to many cover out-of-network claims and apply in-network cost sharing. The law applies to both job-based and non-group plans, including grandfathered plans.
2) Prohibiting doctors, hospitals, and other covered providers from billing patients more than in-network cost sharing amount for certain out-of-network medical bills.
“The problem is that federal authorities have been slow to enforce these measures, leaving patients in the lurch,” Talento says. “Between the price transparency rules and the No Surprises Act, health care consumers should be able to take charge of their health care costs. But for too many, this hasn’t been the case.
“Patients — especially those with health insurance — are always the ones who get stuck with the bill and there’s no one to help them. The No Suprises Act is supposed to stop the price gouging,” she adds. “But the whole health care system is in chaos. This is why an increasing number of Christian doctors are refusing insurance and partnering with patients who are members of Health Care Sharing Ministries.”
One of those is Dr. Chad Savage, of YourChoice Direct Care in Brighton, Michigan. “Years ago, when I left my hospital-employed position, I looked at health care options,” Dr. Savage says. “I knew what was happening in the insurance-based practice of medicine and wanted to avoid it. When I learned how cost-effective [Health Care Sharing] was and the fact that it stressed Biblical principles, it was a no-brainer to switch over.”
“In the No Surprises Act, Congress established an arbitration process to make the system work between doctors, hospitals and insurers,” Talento explains. “But the government has not implemented this system effectively and it’s leading to long delays in resolving disputes, putting the whole No Surprises Act effectiveness in jeopardy.”
“Republicans on the House Ways and Means are trying to see that the laws are enforced so that the broken, third-party payer system is not stacked against the patients.”
Twenty-five members of the U.S. House Ways and Means Committee sent a letter on Nov. 9 to federal officials asking why transparency enforcement in health care has been lacking. Addressed to Health and Human Services Secretary Xavier Becerra, Treasury Secretary Jane Yellen and Acting Secretary of Labor Julie Su, the letter stated:
“We ask that you swiftly revisit the final rule, ensure that it aligns with the law as written, and take immediate steps to make the law’s transparency provisions a reality for patients.
“In the No Surprises Act, Congress created an arbitration process to ensure a fair balance when settling payment disputes between health insurers and out-of-network providers while protecting patients from surprise medical bills. As the Committee discovered during its hearing about the Biden Administration’s flawed implementation of the law, the independent dispute resolution (IDR) process established by the Administration’s rulemaking is failing to fulfill Congress’ intent.”
Earlier, at a Ways and Means hearing on Sept. 21, committee members summarized the problem:
“Patients are losing access to care and their health insurance covers fewer doctors, while medical providers are struggling to get reimbursed for services provided, all because of the flawed implementation of the bipartisan No Surprises Act of 2020.”
“Health care sharing is an appealing alternative that saves money, leads to better care and more medical freedom,” Talento says. “Christians don’t have to face delays that can hurt their health and finances, nor do they have to be part of a system paying for abortion and other unbiblical practices.”
“Health Care Sharing Ministries should not be confused with health insurance,” Talento adds. “When members go to a doctor or hospital or incur a medical cost, they submit the bill to their community through the ministry. Health Care Sharing Ministry staff can also help patients navigate the medical system and negotiate lower prices. Ministry chaplains are available to pray with members.”
Since 1981, Health Care Sharing Ministries operating in all 50 states have given patients an alternative to health insurance, facilitating the sharing of billions of dollars in medical expenses for their members.
The Alliance represents the majority of large, federally recognized Health Care Sharing Ministries and two-thirds of the more than a million members nationwide. Alliance member ministries have been certified by the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services as meeting the federal definition of Health Care Sharing Ministries in the Affordable Care Act.
Founded in 2007 and headquartered in Washington, D.C., the Alliance of Health Care Sharing Ministries is a 501(c)(6) trade organization representing the common interests of Health Care Sharing Ministries which are facilitating the sharing of health care needs (financial, emotional, and spiritual) by individuals and families, and their participants. The Alliance engages with federal and state regulators, members of the media, and the Christian community to provide accurate and timely information on health care sharing.
To learn more about the Alliance of Health Care Sharing Ministries, visit www.ahcsm.org or follow the ministry onFacebook or Twitter.
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To interview a representative from The Alliance of Health Care Sharing Ministries, contact Media@HamiltonStrategies.com, Beth Bogucki, 610.584.1096, ext. 105.
To interview a representative from The Alliance of Health Care Sharing Ministries, contact Media@HamiltonStrategies.com, Beth Bogucki, 610.584.1096, ext. 105.