Maine State Senators Present Legislation to End Abusive Billing, Prioritize Patients at Public Hearing

AUGUSTA, Maine, Feb. 27 -- The Maine Senate Democrats issued the following news on Feb, 26 on behalf of Maine State Sens. Troy Jackson, D-Allagash and Ned Claxton, D-Auburn:

Legislative Democrats' Patients First health care reform package received a public hearing before the Legislature's Health Coverage, Insurance and Financial Services Committee on Tuesday. The Patients First package is a suite of health care reform bills - sponsored by Senate President Troy Jackson, D-Allagash, Speaker Sara Gideon, D-Freeport, and Sen. Ned Claxton, D-Auburn - that advocate for Maine health consumers, protect against abusive and surprise billing practices, and limit the cost of insulin for some Mainers.

"There's no doubt that health care is complicated. It's why politicians have often thrown up their hands in frustration. But that ends today. Just because it's complicated doesn't mean putting patients first should be," said President Jackson. "We all know people who have lost their lives because getting the care they need was too expensive. I often tell the story about my friend Ryan Kelly, who left behind a wife and young child when he died of a heart attack in his mid-20s. The reason I tell this story is to remind people that behind the numbers - the one in seven Mainers who skip health care because of cost - are real people. They're our friends, family members and neighbors. And there are real consequences when they can't afford their health care."

A bill from President Jackson - LD 2110, "An Act to Lower Health Care Costs" - establishes the Maine Commission for Affordable Health Care to rein in rising health care costs and develop a process for effective, data-driven reforms. Nine other states, including Massachusetts and Vermont, have similar health care commissions that have delivered significant savings. In Massachusetts, the Health Policy Commission saved patients and businesses $7.2 billion. In Vermont, the Green Mountain Care Board saved rural hospitals $7.3 million.

"When I hear about Mainers rationing their medication or losing their life-savings despite being insured, I know our health care system requires major reform," said Speaker Gideon. "With ongoing uncertainty at the federal level, it's critical that we do everything we can at the state level to ensure stability and predictability for Maine families and businesses. With this suite of bills, we are leading the way and putting patients first. Legislative Democrats are committed to driving down costs and increasing accessibility for all Mainers."

Two bills in the Patients First health care package are from Speaker Gideon. The first bill would cap the out-of-pocket cost of insulin at $100 for patients in the individual and small group markets. The second bill protects patients from high-cost bills from out-of-network providers when they never had an opportunity to choose a cheaper option. A recent study shows that one in five inpatient emergency department cases may lead to surprise bills.

Another bill from Sen. Claxton - LD 2111, "An Act to Establish Patient Protections in Billing for Health Care" - puts an end to abusive billing practices, promotes billing transparency and establishes basic billing protections for patients. Almost 70 percent of Americans are worried about unexpected medical bills. This legislation would require health care providers to be upfront about facility fees, alert patients when they have been referred out-of-network and bill patients within a reasonable time frame.

"Throughout my career, I did everything I could to provide my patients with the best possible care. The last thing I want to see is the patients I know and love going bankrupt from going to the doctor," said Sen. Claxton, a retired family physician. "These abusive billing practices and obscure fees are at odds with the oath we take as doctors. It's why I've introduced legislation to protect patients from abusive and confusing billing practices. My proposal is about putting patients first, making sure they're treated fairly and are able to make informed decisions."

Lawmakers were joined by patients, seniors and health care advocates who testified in favor of the bill package.

"Last year, my daughter needed medical care. She went to an in-network primary care provider and was referred to a local specialist. The next thing we know, she received a $9,500 out-of-network medical bill. Nobody ever told us the provider she was referred to was not in her plan's network," said Brenda Bonneville of Belfast. "Patients should be given the information they need to make informed decisions about their care. This is why I urge Maine's Legislature to pass the bills included in the Patients First Health Care Package, to ensure other Mainers don't get stuck with expensive and unexpected medical bills because they were never informed that a provider wasn't covered by their health plan."

President Jackson, Speaker Gideon, Sen. Claxton and Legislative Democrats unveiled these major health care reform bills alongside patients, health care advocates and providers at a press conference earlier this month.

The committee will continue to work on all four proposals at a work session on Thursday.