Good news for a change! Federal law intended to limit “surprise” medical bills appears to be working

April 27, 2023

When it comes to health care costs, Voices for Affordable Health often shares sobering news. But a new study from the Urban Institute and the Georgetown University Center on Health Reforms finds a new federal law intended to protect patients from excessive and unexpected medical bills is having a positive effect.

“Surprise” or “balance” bills often happen when patients are treated by a clinic or hospital in their insurance network but are seen by a doctor or specialist who isn’t. The patient is then on the hook for what is often a very high bill – sometimes exceeding thousands of dollars. 

The “No Surprises Act,” which became federal law in January 2022, was designed to limit such out-of-network charges.

Researchers interviewed 32 regulators and stakeholders representing consumers, payers, hospitals, billing companies and other industry players. They found a marked decline in consumer complaints since the “No Surprises Act” took effect.

“One consumer group, which fielded a significant number of surprise billing complaints in past years, reported having not received one complaint about No Surprise-Act surprise billing in 2022,” the researchers wrote. “Similarly, an employer coalition said that before the No Surprises Act, there was enough noise to know there was a problem (with balance billing); since then, we have no noise in this area.”

Before we break out the party hats and balloons, researchers noted that it’s still far too early to draw any long-term conclusions. More work needs to be done to educate consumers about their rights. And the year has pointed to some coverage gaps – including ground ambulance services – where Congress may need to tighten protections.

Have you received a “surprise” medical bill in the past year? We’d love to hear about it. Share your story with Voices for Affordable Health.