Healthcare Providers Pen Letter Urging Lawmakers To Oppose Out-of-Network Price Caps

This week, a coalition representing healthcare providers from across the state, including the Connecticut Hospital Association (CHA), penned a letter to the Connecticut General Assembly’s Insurance and Real Estate Committee urging lawmakers to oppose HB 6871, An Act Limiting Out-Of-Network Health Care Costs, and the policies contained in Governor Ned Lamont’s biennial budget proposal that would cap out-of-network payment for hospital inpatient and outpatient services.

“We write to you today as a unified group of healthcare providers who are committed to continue providing the highest quality and most accessible care possible to our patients and communities,” the coalition wrote.  “To do that, we must work together to remove barriers to high-quality care, life-saving innovation, and build a strong healthcare workforce.  The proposed out-of-network caps would only strain healthcare providers further and create more barriers to care while benefiting insurance companies.”

HB 6871 would cap out-of-network payment for hospital inpatient and outpatient services at 240% of Medicare or at a different amount determined by the Office of Health Strategy (OHS) through regulation.  This policy could lead to more than $700 million in reduced payments to hospitals, jeopardizing hospitals’ ability to sustain current levels of access to services for patients and recover from challenges of recent years, including a global pandemic, surging inflation, and a workforce crisis.

During deliberations ahead of the committee’s vote on Tuesday, March 11, multiple legislators spoke out against HB 6871, recognizing the detrimental impact of the bill that would threaten patients’ access to essential services and undermine ongoing efforts to recover the financial health of hospitals, health systems, and other providers.

“This is a bad bill on a good day, and it’s a terrible bill on a bad day.  This is not moving the needle forward.  This is moving the needle way back,” said Insurance and Real Estate Committee Vice Chair Senator Saud Anwar. 

“We have to go back to the basic idea of doing no harm,” Anwar added, urging fellow committee members to reject the bill.  He implored them to consider the unintended consequences of advancing a proposal that would deal another devastating blow to healthcare providers already facing enormous economic headwinds.  Senator Martha Marx echoed Anwar’s concerns, noting threats to dramatically slash the Medicaid program on the federal level.

“I am very fearful of what this bill will do.  And I also think with the impending promise — and it is pretty much a promise right now — of severe cuts to Medicaid, that our hospitals won’t be able to handle that, never mind this,” Marx remarked.

As lawmakers continue to review HB 6871, healthcare providers warn its passage would result in unsustainable losses to hospitals, creating ripple effects throughout the healthcare delivery system that leave patients with fewer options for care and make it even harder for healthcare providers to invest in new technologies and innovative treatments.  Additionally, by imposing these new reimbursement restrictions, the bill would disincentivize physicians from practicing in Connecticut at a time when the workforce shortage is as severe as ever.  If physicians leave the state, Connecticut patients will suffer from longer wait times, fewer specialists, and reduced accessibility, ultimately exacerbating the health disparities that providers are diligently working to address.

Click here to download and share a fact sheet with valuable information on out-of-network price caps.

Click here to learn more about harmful policies in the governor’s proposed budget.

Click here to read the Connecticut Hospital Association’s (CHA) testimony opposing the bill.

Click here to read the coalition’s letter to the Insurance and Real Estate Committee.