AUGUSTA – Speaker Sara Gideon today presented LD 2105 – An Act To Protect Consumers from Surprise Emergency Medical Bills. This bill amends Maine’s existing law providing consumer protection for surprise medical bills to include surprise bills for emergency services.  

Speaker Gideon’s submitted written testimony is below.

Senator Sanborn, Representative Tepler and distinguished members of the Joint Standing Committee on Health Care Insurance and Financial Services, thank you for welcoming me today. I am Sara Gideon, from Freeport and the Speaker of the House of Representatives. I’m here today to speak in favor of LD 2105 – An Act To Protect Consumers from Surprise Emergency Medical Bills.

This bill amends Maine’s existing law providing consumer protection for surprise medical bills to include surprise bills for emergency services.  

Surprise medical billing, which often takes the form of “balance billing” for out-of-network medical care, is one of the most pressing health and affordability challenges facing patients and their families, with millions of Americans receiving unexpected and unaffordable medical bills every year. These bills often include exorbitant charges that are far greater than in-network rates and can cost consumers thousands or even tens of thousands of dollars. These expenses can push household budgets past the breaking point, or cause consumers to forgo desperately needed care for fear they won’t be able to afford it.

The Legislature recognized this and that is why in 2017, with broad, bipartisan support, we passed a bill to combat this very problem. However, at the time, the law did not apply to emergency medical services. 

In an emergency, a patient should be focused on one thing: getting the care they need as quickly as possible. They should not be considering whether a particular hospital,  emergency room doctor, surgeon or anesthesiologist is in their insurance network. In emergency situations, consumers often have no real ability to choose their provider, nor should they be asked to make those types of decisions. 

A recent study shows that one in five inpatient emergency department cases may lead to a surprise bill. 

These bills can negatively affect all the players in the healthcare system. When insurance companies are not obligated to pay their fair share, patients may be left with exorbitant bills for the treatment they receive. And emergency doctors, who are required to treat and stabilize all patients regardless of their insurance coverage, may not be compensated for their life-saving care in a way that allows them to continue operating, especially in rural and underserved parts of our state.

This legislation seeks to solve these problems in a few ways, the most important of which, is ensuring patients are taken out of the middle of billing disputes between insurers and providers and held harmless. That means, in an emergency where patients often lack the ability to meaningfully choose their provider, they will only be liable for the charges for which they would have been responsible had they received care from an in-network provider.

The bill also directs the Superintendent of Insurance to develop an independent dispute resolution process to settle disagreements over surprise medical bills and makes the process accessible to uninsured parties who wish to dispute certain surprise medical bills.

I also want to echo something I said during my testimony for the bill related to insulin costs. The only way to end these abusive billing practices for all Mainers – whether insured or not – is comprehensive action at the federal level. Absent that, the need for action at the state level is all the more urgent. Let’s continue to lead here in Maine and help those that we can. 

In closing, now is the time to extend the protections in current law to those receiving emergency medical services, because the last thing that should be on a patient’s mind in an emergency is “can I afford the care I need.”

I am sure there are others that will follow me today that can dive into further details, but I’d be pleased to answer any questions you may have. I’m confident the committee will consider these matters carefully and I respectfully ask that you support LD 2105 and swiftly move its passage.