Saturday December 14, 2019

Trump to Fight Health Care Sticker Shock by Limiting “Surprise Medical Bills”

“Surprise” bills amounting to tens of thousands of dollars can hit patients and their families when they are most vulnerable — after a medical emergency or following a complex surgical procedure

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health care, surprise medical bills
FILE - A doctor speaks to a patient in an emergency room at Northside Hospital in Cumming, Georgia, Jan. 29, 2018. VOA

President Donald Trump will begin a push Thursday to fight health care sticker shock by limiting “surprise medical bills,” the unexpected charges faced by insured patients when a member of a health care team that treated them is not in their insurer’s network.

Senior administration officials told The Associated Press the Republican president will outline principles he can support as part of legislation to limit such billing practices. Republican and Democratic lawmakers have been trying to make progress on the topic for months, and White House support improves chances that something will get done.

Patients being treated for medical emergencies often are in no position to check into whether their insurers have contracted with their surgeons or anesthesiologists to provide medical care. Trump wants to make it clear that patients who receive emergency care should not be hit with charges that exceed the amount paid to in-network providers.

health care, surprise medical bills
Trump wants to make it clear that patients who receive emergency care should not be hit with charges that exceed the amount paid to in-network providers. VOA

“Surprise” bills amounting to tens of thousands of dollars can hit patients and their families when they are most vulnerable — after a medical emergency or following a complex surgical procedure. Often patients are able to negotiate lower charges by working with their insurers and the medical provider. But the process usually takes months, adding stress and anxiety.

The officials said the legislation also should protect patients seeking elective care by ensuring that they are fully informed before scheduling their care about which providers will be considered out of network and what extra costs that will generate.

The officials spoke on the condition of anonymity because they were not authorized to speak publicly on the matter before Trump’s announcement. The White House effort is part of a broader push by the Trump administration to increase transparency in the health care system. On Wednesday, the administration finalized regulations requiring drug companies to disclose list prices of medications costing more than $35 for a month’s supply.

surprise medical bills, health care
Patients being treated for medical emergencies often are in no position to check into whether their insurers have contracted with their surgeons or anesthesiologists to provide medical care. VOA

The president also will make the case that legislation should not lead to additional costs for taxpayers. Insurers form networks of doctors and hospitals, in part, to gain some leverage for negotiating reimbursements. Usually patients pay a bigger share of the bill for any care sought outside those networks.

But sometimes, patients don’t know they got care outside of their network until they get their bill. A House panel held a hearing on surprise medical bills last month. Trump also participated in a January meeting with health care advocates and victims of surprise billing. The officials said Trump made clear following the meeting that he wanted his administration to work on finding a fix.

States also have been working to protect consumers from surprise medical bills. A survey of states by Georgetown University found that about half the states have acted to protect consumers, but some, such as California, Connecticut, Florida and a handful of others, have the most comprehensive protections. But states don’t have jurisdiction over most health plans sponsored by large employers, which cover about 100 million people and operate under the umbrella of a federal law.

surprise medical bills, trump, health care
“Surprise” bills amounting to tens of thousands of dollars can hit patients and their families when they are most vulnerable — after a medical emergency or following a complex surgical procedure. Pixabay

A coalition that includes major insurers, business groups, and consumer organizations has been pressing Congress for federal legislation. The basic elements would include informing patients when a doctor or service provider is out-of-network, setting a federal standard for what out-of-network clinicians can charge, and guaranteeing that the changes do not lead to premium increases.

ALSO READ: British Royals Launch Messaging Service to Help People Suffering from Mental Health Crisis

But a major hang-up has been agreeing on payment rates for out-of-network services that are mutually acceptable to medical specialists, hospitals and insurers, who have conflicting interests.

Jack Hoadley, a research professor emeritus at Georgetown, told lawmakers last month that unexpected medical bills are a major concern for consumers, with two-thirds of Americans saying they are “very worried” or “somewhat worried” that they or someone in their family will receive a surprise bill. He said programs like Medicare, Medicaid and veterans care protect consumers from out-of-network bills. But the same protections do not exist for most private insurance. (VOA)

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Trump to Pursue Higher Sales Age for Vaping Devices: ‘An Age Limit of 21 or So’

Trump told reporters his administration will release its final plans for restricting e-cigarettes next week but provided few other details

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Trump, Sales, Vaping
President Donald Trump speaks to reporters on the South Lawn of the White House in Washington, Nov. 8, 2019. VOA

President Donald Trump said Friday his administration will pursue raising the age to purchase electronic cigarettes from 18 to 21 in its upcoming plans to combat youth vaping.

Trump told reporters his administration will release its final plans for restricting e-cigarettes next week but provided few other details.

“We have to take care of our kids, most importantly, so we’re going to have an age limit of 21 or so,” said Trump, speaking outside the White House.

Currently the minimum age to purchase any tobacco or vaping product is 18, under federal law. But more than one-third of U.S. states have already raised their sales age to 21.

Trump, Sales, Vaping
FILE – A woman buys refills for her Juul at a smoke shop in New York, Dec. 20, 2018. VOA

A federal law raising the purchase age would require congressional action.

Administration officials were widely expected to release plans this week for removing virtually all flavored e-cigarettes from the market. Those products are blamed for soaring rates of underage use by U.S. teenagers.

However, no details have yet appeared, leading vaping critics to worry that the administration is backing away from its original plan.

Trump resisted any specifics on the scope of the restrictions.

Also Read- US Officials Identify ‘Strong Culprit’ in Vaping Illnesses

“We’re talking about the age, we’re talking about flavors, we’re also talking about keeping people working — there are some pretty good aspects,” Trump said.

Mint flavor

Underage vaping has reached what health officials call epidemic levels. In the latest government survey, 1 in 4 high school students reported using e-cigarettes in the previous month.

Fruit, candy, dessert and other sweet vaping flavors have been targeted because of their appeal to underage users.

Trump, Sales, Vaping
FILE – A man blows a puff of smoke as he vapes with an electronic cigarette, Oct. 18, 2019. VOA

On Thursday, Juul Labs, the nation’s largest e-cigarette maker, announced it would voluntarily pull its mint-flavored e-cigarettes from the market. That decision followed new research that Juul’s mint is the top choice for many high school students who vape.

With the removal of mint, Juul only sells two flavors: tobacco and menthol.

Vaping critics say menthol must be a part of the flavor ban to prevent teens who currently use mint from switching over.

‘Tobacco 21’ law

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Juul and other tobacco companies have lobbied in support of a federal “Tobacco 21” law to reverse teen use of both e-cigarettes and traditional tobacco products. The effort also has broad bipartisan support in Congress, including a bill introduced by Senate Majority Leader Mitch McConnell.

The logic for hiking the purchase age for cigarettes and other products is clear: Most underage teens who use e-cigarettes or tobacco get it from older friends. Raising the minimum age to 21 is expected to limit the supply of those products in U.S. schools.

Delaying access to cigarettes is also expected to produce major downstream health benefits, with one government-funded report estimating nearly 250,000 fewer deaths due to tobacco over several decades.

Still, anti-tobacco groups have insisted that any “Tobacco 21” law must be accompanied by a ban on flavors, which they say are the primary reason young people use e-cigarettes. (VOA)