1 in 6 ER visits or hospital stays triggers ‘surprise’ bill

By RICARDO ALONSO-ZALDIVAR
June 20, 2019

WASHINGTON (AP) — Roughly one in every six times someone is taken to an emergency room or checks in to the hospital, the treatment is followed by a “surprise” medical bill, according to a study released Thursday. And depending on where you live, the odds can be much higher.

The report from the nonpartisan Kaiser Family Foundation finds that millions of people with what’s considered solid coverage from large employers are nonetheless exposed to “out-of-network” charges that can amount to thousands of dollars. It comes as congressional lawmakers of both parties and the Trump administration move to close the loophole, with a Senate panel scheduled to vote on legislation next week.

A patient’s odds of getting a surprise bill vary greatly depending on the state he or she lives in. Texas seems like a bit of a gamble, with 27% of emergency room visits and 38% of in-network hospital stays triggering at least one such bill. Minnesota looks safer, with odds of 2% and 3%, respectively.

Researcher Karen Pollitz of the Kaiser Foundation said the reasons for such wide differences are not entirely clear, but seem to be related to the breadth of hospital and doctor networks in each state, and the ways those networks are designed.

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