The following guest column by NFIB/FL Executive Director Bill Herrle was published in the South Florida Sun Sentinel November 12, 2015 on the growing healthcare burden on small businesses and their employees stemming from the practice of balance billing.
Thursday, November 12, 2015
and families across Florida are feeling the enormous burden of increased health
care costs thanks to the Affordable Care Act. Unfortunately, rising premiums
and higher deductibles are just the beginning of the problems.
have preferred provider organization health plans — that’s more than half of
the state’s consumers — are getting hit at an alarming rate with balance bills,
a practice where health care providers bill consumers for the balance of the
retail charges for medical services after various payments to the health care
providers are made.
most often occurs after an individual who, in an emergency situation, is
treated by an out-of-network provider. The result is a surprise medical bill
ranging from hundreds to tens of thousands of dollars or more, well above the
individual’s co-payment and the amount the insurer has reimbursed to the
emergencies, so many Floridians who do their due diligence — ensuring that they
go to an in-network hospital and are to be treated by an in-network doctor —
are still becoming victims to surprise balance bills. Any physician performing
services on them in an in-network hospital may be out of their network — an
anesthesiologist, a radiologist, etc. With no warning, these vigilant consumers
are being hit with surprise balance bills.
Take an example
from Florida’s Insurance Consumer Advocate who represents Florida consumers on
behalf of CFO Jeff
Following an MRI, a Boca Raton woman was diagnosed with a brain tumor and sent
for emergency surgery by her doctor. She went to an in-network hospital and was
operated on by an out-of-network neurosurgeon. The result: a surprise balance
bill of $81,890, despite having health insurance and going to an in-network
Why does it seem
like well-informed, insured Floridians are always left holding the bag? Leaving
Florida’s employees with astronomical surprise bills is exactly the type of
abuse that Gov. Rick Scott has been standing up against, and we hope to see the
governor add balance billing to the health care billing grievances he’d like to
Carlos Trujillo, R-Miami, has taken an important step by filing House Bill 221.
HB 221 would prohibit health care providers from balance billing for PPO plans
and give Florida consumers much-needed relief from these surprise balance bills
when receiving emergency care — a protection that’s already in place in Florida
for consumers who have health maintenance organization insurance plans.
At the National
Federation of Independent Business, the largest small business advocacy
association in Florida and Washington, D.C., we have a record of standing up
against Obamacare. We took our case all the way to the U.S. Supreme Court; and
now, we’re standing up to protect Florida’s business owners and their employees
by putting an end to surprise balance billing.
We thank Rep.
Trujillo for making Florida’s consumers one of his top priorities, and we urge
the Legislature to stand with us and adopt the good public policy in HB 221
during the 2016 Legislative Session.
Bill Herrle is
the executive director of the National Federation of Independent Business.