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Throughout 2020, health care has dominated front page headlines due to ongoing concerns caused by the spread of COVID-19. In Wisconsin and other states across the U.S., lawmakers and health officials have scrambled to learn more about the virus and educate Americans on how best to protect themselves and their families. Unfortunately, underlying this health crisis has been another issue that affects medical providers and patients alike, as surprise medical bills remain a major problem.

Surprise medical bills come about when patients go to the hospital for emergency medical care or visit a doctor at a facility in their network expecting that insurance will cover their treatment, but later on receive a massive bill. It’s a problem that Wisconsin lawmakers have been looking to address since even before the COVID-19 outbreak, and now as the COVID-19 pandemic continues to spread, it is more important than ever before that we find an answer.

Some areas have already seen instances where patients are treated for COVID-19, only to recover and immediately need to fight with their insurance company to get the coverage they need. To protect Wisconsin patients, we need our leaders to embrace a solution that provides relief for Wisconsinites not just in the short-term, but for long after COVID-19 has passed.

One possible path that some policymakers have proposed is to institute a system where the government is responsible for setting rates. This, however, will only end up making the problem worse. With the government dictating prices, big insurance companies will be able to use their powerful lobbyists to leverage the government into setting rates that best suit their needs instead of the needs of patients. In the end, rates would be artificially deflated so drastically that smaller medical providers would be left without a way to make up for all the lost revenue.

That would create serious problems for the more than 1.5 million Wisconsinites who live in rural areas. Smaller practices provide critical care for people across the state who can’t afford to make the drive to a larger city for treatment and losing those facilities because they can’t afford to operate anymore would be an incredible detriment to health care in our state. Any legislative response must prioritize protecting these facilities, otherwise the repercussions could be catastrophic.

Thankfully, President Trump and many in Congress are already working toward a solution that will protect rural medical providers and patients. For example, Senator Bill Cassidy (R-LA) has proposed legislation called the STOP Surprise Medical Bills Act (STOP Act). The bill would implement a fair arbitration process to help protect patients and medical workers. A similar system has been implemented in both New York and Florida, and has seen immense success in both states.

The STOP Act is a forward-thinking solution that’s rooted in conservative ideals. Senator Cassidy’s proposal would make sure that hospitals are properly paid for the services they provide without sticking patients with the bill. It’s a common-sense approach, and one that I am sure would help health care in Wisconsin.

President Trump has made it clear that he wants to fix surprise medical billing. Now, we need our Congressional leaders such as Senator Mitch McConnell and other lawmakers to show a similar dedication in support of the STOP Act. Patients and providers are already struggling, and they cannot afford to contend with a government rate-setting approach.

The coming months are absolutely critical for health care in the U.S. COVID-19 will test the systems we have in place, and surprise medical billing will only exacerbate any stresses caused by the virus. Wisconsin health providers and patients alike need relief, and the STOP Act will provide that for them in the form of a responsible long-term fix.

–Hughes is a registered nurse from Madison.


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