Lawmakers face distractions from Iran, impeachment in bid to get deal on surprise billing

Capitol building in Washington
Lawmakers returned from their holiday break to address issues with Iran and impeachment while healthcare priorities linger. (rarrarorro/iStock/Getty Images Plus/Getty Images)

Lawmakers concede escalating tensions with Iran and impeachment could cripple progress on deals for surprise billing as a stalemate over how to pay providers lingers.

Congress returned to work earlier this month after the holiday break to pressing debates about President Donald Trump’s war powers and a looming impeachment trial. Some lawmakers admitted they were fed up with the lack of progress on legislation to tackle surprise medical bills.

“I think everyone involved knows that this has to be resolved,” said Rep. Anna Eshoo, D-California. “As far as I am concerned ASAP. I don’t want to wait around.”

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But other priorities are reaching the forefront. Chief among them is a debate about Trump’s war powers after a U.S. drone strike killed top Iranian commander Qassem Soleimani.

“The exercise we are getting ready to go through on war powers is another good example of something that gets in the way,” said Rep. Tom Cole, R-Oklahoma, before heading to a vote last week on a resolution seeking to curb Trump’s war powers.

RELATED: One reason surprise billing solutions are so tricky for hospitals

The Senate, meanwhile, is gearing up for an impeachment trial of Trump.

Sen. Tim Kaine, D-Virginia, conceded that the pressing issues of impeachment and Iran could become impediments to get something done on surprise billing. But, he quickly added, “there is no reason we can’t reach an agreement." Kaine then headed into a Senate briefing from the White House on Iran. 

Lawmakers didn’t include legislation on surprise billing in an end-of-year spending package. But in that package, Congress only reauthorized funding for key health programs until May.

The thinking was to create a new deadline for Congress to get something done on surprise billing and other healthcare legislation. However, the Senate is waiting on the House to sort out a way forward.

RELATED: Lawmakers try to find the next opportunity to tackle drug prices, surprise billing after setback

How to pay providers has remained a key sticking point, as providers endorse arbitration to settle disputes on out-of-network charges and payers a benchmark rate for out of network. Provider groups, some of which are backed by private equity firms, and insurers have launched massive ad campaigns over the issue.

The House Energy and Commerce Committee and the Senate Health, Education, Labor and Pensions Committee reached a deal last year that uses a benchmark rate and an arbitration backstop for any charges above $750. But the House Ways and Means Committee announced shortly thereafter they are working on their own legislation that may be more provider-friendly.

The stalemate has continued into the new year.

House Majority Leader Steny Hoyer told reporters last week that he is turning to the committee chairmen to settle any dispute, according to a report in The Hill newspaper. Energy and Commerce Committee Chairman Rep. Frank Pallone, D-New Jersey, calls tackling “devastating” surprise medical bills one of his top priorities, a committee spokesperson said.

Another area that has stalled in Congress is drug prices. The spending package did include legislation such as the CREATES Act that aims to curb unfair tactics brand-name drugmakers use to stymie generic competition.

But the Senate refuses to consider legislation from Sen. Chuck Grassley, R-Iowa, that would put an inflationary cap on Medicare Part D drug prices. A House bill to give Medicare the power to negotiate for lower drug prices is also stuck in the Senate. Grassley said he will need help to get the bill to the floor.

“It is going to be difficult until I get more Republican co-sponsors,” he said of his bill that narrowly passed out of the Senate Finance Committee last year. “I have been reaching out to them all the time.”

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