Conservative Group Wants to Steer Lamar Alexander and Other Legislators Toward Market-Based Solutions on Health Insurance

The Washington, D.C.-based Heritage Action last week argued against U.S. Republican Sen. Lamar Alexander’s Surprise Medical Billing legislation and said conservatives must steer legislators away from what it called “the heavy hand of big government.”

Members of Heritage Action, in a toolkit members released last week, also said people must turn legislators toward market-based solutions.

“Government intervention has caused market distortions, introducing fixes that make matters worse,” according to Heritage Action.

“A prime example is the Affordable Care Act (Obamacare), which for most Americans, has only led to higher insurance premiums and fewer choices in the healthcare marketplace,” Heritage said.

Members of Heritage Action said members of the U.S. House and U.S. Senate are debating a number of bills to address Surprise Medical Billing and also Medicare Part D and Medicare Part B.

But many of those bills, Heritage went on to say, contain government-mandated price controls that warrant conservative opposition because “they ignore basic economic principles and have unintended consequences.”

“Many Americans receive their prescriptions through Medicare Part D, and plans and manufacturers are currently incentivized to push high-cost Medicare patients into the ‘catastrophic tier’ of prescriptions, where the taxpayers must cover 80 percent of the prescription costs,” according to Heritage Action.

“And under Medicare part B, physicians are financially incentivized to prescribe more expensive drugs when cheaper alternatives are available. Additionally, current laws and regulations make it unnecessarily difficult for drug manufacturers to introduce new, cheaper generics into the marketplace.”

Among Heritage’s proposed solutions:

• Congress should reject any deal that contains price controls and remove bureaucratic red tape, increase price transparency for consumers, and better align market incentives.

• Congress should require healthcare providers to supply a good-faith estimate of the cost of scheduled medical care before it occurs and establish penalties for any insurer that falsely represents a facility as being in-network, and for any provider practice that presents itself as being in-network if doctors at that practice balance-bill for services.

• Congress should use existing rules to ban balance billing for non-network emergency care.

• Congress should restructure the Part D program to disincentivize plans and manufacturers from pricing drugs at a level that would place them in the catastrophic tier. Additionally, placing a limit on reimbursements under Part B would eliminate a perverse incentive for doctors to prescribe more expensive medicines. And lastly, Congress should close loopholes in federal law that prevent market competition between brand-name manufacturers and their generic competitors.

• Conservatives should urge lawmakers to reject price controls and instead adopt conservative solutions that remove bureaucratic red-tape, reform existing programs, and create more choice and transparency in the healthcare marketplace for consumers.

As The Tennessee Star reported in July, surprise medical billing happens when a patient receives out-of-network care without his or her knowledge – either in an emergency or during a visit to an in-network facility. Weeks later, insurance companies send bills demanding patients pay money for services they assumed insurance would cover.

Members of Americans for Prosperity, the Center for a Free Economy, FreedomWorks, Institute for Liberty, and the Taxpayers Protection Alliance, among others, oppose what Alexander is doing.

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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to [email protected].  

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