John Daley, CPR News

A new law meant to limit unexpected medical bills will take effect on the first day of 2020.

The issue received rare bipartisan support in the previous legislative session, as Colorado lawmakers heard from constituents about the need for protection against surprise sky-high medical bills. Zoe Williams, a mom who lives in Denver, told lawmakers her story at a news conference when the bill was introduced.

Williams said she took her 3-year-old to an emergency room at an out-of-network hospital for a broken leg.

The bill was $15,000.

“All of these accounts went to collections, it impacted our credit,” Williams said. “I had actually just found out I was accepted into law school, and almost had to not go to school because I couldn’t qualify for my loans, which required a certain amount of credit in order to access them.”

Similar measures had failed in prior legislative sessions

Now, health care facilities and providers will have to be clearer about when charges may be out of network. The new law caps what out-of-network doctors can charge at in-network hospitals and creates an arbitration process to handle billing disputes.

In the time before the new law, Adam Fox, director of strategic engagement for the Colorado Consumer Health Initiative, said there were some cases where insurers charged 200 or 300 times what Medicare pays for the same service.

“They’ve been charged more than $200,000 when Medicare would pay $520 for the same service,” Fox said. “Or $70,000 when Medicare would have paid $338.”

Fox said those high costs get passed on to consumers through higher premiums.

Opponents of the legislation argued that capped reimbursement rates would drive the best doctors out of Colorado and encourage the worst to come to the state. Proponents said the legislation was needed because more and more Colordans were getting hit by surprise out-of-network bills.

“These are not one-off stories, but the ones many Coloradans have experienced, too many Coloradans,” said Democratic Rep. Daneya Esgar, one of the bill’s sponsors.

Similar legislation stalled on its way through the U.S. Congress at year’s end. National lawmakers struggled to find common ground and to balance the competing needs of powerful interests and consumers staring down high bills. In the meantime, polling indicates high health care costs are a top priority for voters. President Donald Trump called on Congress in 2019 to pass legislation to end surprise medical bills.

Translate »