As a member of the Committee on Health Coverage, Insurance and Financial Services, I understand the challenges Maine faces in providing quality care at affordable costs.

Surprise medical billing — when a patient receives out-of-network care and is later hit with excessive bills for the costs not covered by their insurance — is a problem that demands a national solution. However, it does not require an abdication of free market ideals.

Yet, some of the solutions under consideration in Congress include a benchmark approach, which undermines the free market system that encourages competition and lowers prices. Utilizing benchmarks would lead to the government determining rates paid to physicians performing out-of-network care. That would artificially distort the market.

In turn, it would lead to greater provider consolidation that would yield higher prices, fewer options and diminished access to care for patients in Maine.

A better solution is needed and, fortunately, there are other bills in Congress that take an approach firmly rooted in the free market by using what is known as independent dispute resolution.

IDR establishes a fair negotiation process that incentivizes both parties to submit their best “offer” via an online portal. After no longer than 30 days, an independent mediator would determine a fair payment. In the meantime, providers would receive a market-based interim payment based to help ensure financial solvency, particularly for rural health care centers.

Maine’s entire congressional delegation should work to ensure that any legislation passed by Congress includes IDR and not the anti-free-market benchmark approach.

Joshua Morris, Turner


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