As Debbie Moehnke waited for a doctor to look at her swollen feet in a Vancouver, Wash., clinic, she began struggling for breath.
“I can’t breathe, I can’t breathe,” she told her husband.
Moehnke was rushed to a hospital, where she was stabilized. The next day, she was taken a few miles away to Oregon Health & Science University in Portland. There, she underwent heart bypass surgery and treatment for a serious infection that developed while she recovered from surgery.
When she returned home after nearly a month in the hospital, Moehnke received a surprise bill for $226,591.
The Moehnkes assumed their health insurance would cover most of their medical expenses. It always had. They were never told that the hospital — which is less than 30 minutes from their home in Washougal — and some of the doctors were not in their health-insurance network.
“I wish I would have known (how much we would be asked to pay),” Moehnke told a reporter. “I would have said ‘no’ to life support.”
In other words, Moehnke thought it might’ve been better to die than to face nearly a quarter-million dollars in unexpected medical bills.
Such surprise bills, or “balance bills,” typically occur when a hospital or doctor chooses not to participate in an insurance company’s network. Under this arrangement, an out-of-network doctor can bill patients the difference between what insurance covers and the remaining cost, often adding up to tens, if not hundreds, of thousands of dollars.
Coverage by The Seattle Times and Time magazine turned Moehnke’s story into national news. At that point, a major consumer advocacy group and the Washington Insurance Commissioner intervened and helped Moehnke have her debt forgiven through a rare and complex medical charity care waiver.
Surprise billing has become such an epidemic that eliminating surprise bills would reduce Americans’ health insurance premiums by as much as $38 billion a year, according to research by the Brookings Institution.
A recent state law aimed at curbing surprise medical bills is a step in the right direction. But a national law is necessary in order to provide true protection against surprise medical billing — and the lame-duck session that will convene now that the election is over is the last best chance to pass such a bill. The ongoing surge in COVID-19 cases and the increase in hospitalizations makes the timing even more critical.
The Senate Committee on Health, Education, Labor and Pensions (HELP) passed legislation that would protect all patients like Debbie Moehnke by banning balance billing in situations where patients are involuntarily treated by an out-of-network provider. It would also establish reasonable, market-based payment for out-of-network medical services, ensuring that health-care providers are paid fairly and patients aren’t ripped off.
Anti-surprise medical bill legislation has widespread, bipartisan support in both the House and the Senate. But prioritizing the legislation in the coming days and weeks is vital if Congress is serious about tackling the problem.
After new members of Congress take office, the focus will again divert away from the issue of surprise medical bills, putting millions more Americans at risk for unfair, exorbitant charges.
As the most powerful Democrat on the Senate HELP Committee, Washington’s Patty Murray is critical in putting an end to the scourge of surprise bills. Sen. Murray’s support will go far in unifying Democratic support behind the bill and guaranteeing surprise bill reform has the votes necessary to pass in the Senate.
It is more crucial than ever that Congress work to immediately put an end to the despicable practice of ripping off Americans when they’re at their most vulnerable.