Billing, access and Obamacare among hot topics at Shapiro, Wild health care roundtable in Bethlehem

April 17-- Apr. 17--Sarah Rentz said she received an $8,000 bill after her tumor sample was sent to an out-of-network laboratory.

"I was unconscious when they did this. ... Was I supposed to wake up and say, 'No, stay in network'?" she told federal and state policymakers Tuesday at the Miller-Keystone Blood Center in Bethlehem.

Billing was one of a number of health care cost and access issues discussed at the roundtable, which was hosted by Pennsylvania Attorney General Josh Shapiro and U.S. Rep. Susan Wild.

"We've seen a pattern of practice across Pennsylvania where patients are taken advantage of in that situation," Shapiro said Tuesday, adding that state officials sometimes have been able to secure financial help for those patients. Wild said she's working on legislation to keep patients from being billed for something they were unaware of.

The event, held weeks after the Justice Department argued in a court filing that the Affordable Care Act should be tossed, was an opportunity for elected officials to hear patients and health industry experts. Representatives from Lehigh Valley Health Network and St. Luke's University Health Network attended the session, along with patient advocates, including Rentz, who is from Coopersburg, and Brian Kline, a cancer survivor from Quakertown.

Wild, D-7th District, said the roundtable wasn't called in response to the Trump administration's action. Both she and Shapiro have fought to preserve Obamacare against efforts to repeal it.

How is the uncertainty in the ACA affecting you? Shapiro asked around the table.

Health administrators spoke in support of Obamacare, which covers some patients who may be otherwise uninsured. The 2010 law expanded Medicaid coverage, required hospitals to be transparent about costs and held them accountable for the long term health of their patients, among other things. The Hospital and Healthsystem Association of Pennsylvania has supported the ACA.

Health administrators also spoke about the law's shortcomings.

While Obamacare provides coverage, some of the insurance policies are too expensive and don't start covering costs until patients have paid thousands out of pocket, said Dr. Ken Bertka, the vice president of clinical integration at St. Luke's.

"It's important to remember the ACA is about coverage, but that's not the whole story around access," Bertka said.

He highlighted the limited number of primary care residency programs to train new doctors. Wild said she's co-sponsoring legislation to do that.

Other health administrators lobbied for insurers and government payers to cover social services, such as helping patients find transportation, provide counseling and fill out paperwork.

"My department is working with the most vulnerable, lowest income people, and those who are most likely to be uninsured," said Dr. Bonnie Coyle, chairwoman of community health and preventive medicine at St. Luke's. "In a country with the kind of resources that we have, we can find a solution so that we are getting everyone the medical care they need."

LVHN administrators raised a concern about low reimbursement rates from payers and the cost of implementing Obamacare.

Dr. Robert Murphy, chief integration officer at LVHN, said the uncertainty around the health care law makes a tough financial situation more challenging.

The patients at the roundtable pushed for more significant changes, from transparent billing practices to universal health care.

Kline, the cancer survivor, said he's afraid of losing coverage if Obamacare gets repealed.

"Whether it's incremental, a public option or a 'Medicare for All' system," he said. "It's a human right."

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