FAQs on Stop Surprise Billing and Protect Patients Act
The Affordable Care Act bans using pre-existing conditions to deny coverage. Why do we need a state law?
- We need it to close loopholes in the law in Arizona that still allow people to be denied coverage for pre-existing conditions. Gov. Doug Ducey created the loopholes when he signed a law allowing insurance companies to sell so-called temporary plans, often referred to as “junk plans,” that don’t cover pre-existing conditions. [SB1099]
- We need a state law because Congress has tried repeatedly to repeal those protections.
- We need a state law because there’s a lawsuit in federal court aimed at declaring the Affordable Care Act unconstitutional.
- Putting pre-existing conditions into Arizona state law will protect the people of our state no matter what is done at the federal level, and it will be up to the people of Arizona to decide.
Will this increase healthcare costs?
No. Hospitals and insurance companies in Arizona make billions in profits each year and can easily afford these improvements without raising costs, and lowering infection rates in hospitals will save money.
Why do we need infection control in hospitals?
Hospital-acquired infections kill 99,000 people a year in our country at a cost of $20 billion. Arizona hospitals scored worse than national benchmark for incidences of the life-threatening bacterial infection known as C. Diff. Hospitals are supposed to treat and cure, not make patients sicker. This initiative will reduce deaths and lower costs, allowing hospitals to focus on improving patient care.
Do health care workers really need a raise?
Hospital workers in Arizona tell us they see co-workers leave employment in their hospitals time and time again because the pay is so low. That means we are losing quality, professional caregivers with years of experience, some leaving the profession altogether and some going to other states that pay better wages. Using 2018 publicly available data, the job classifications subject to our initiative earn an average salary of $51,896. That number drops to $40,643 when registered nurses are excluded from the calculation. Hospital worker shortages have real consequences for patients, such as emergency room overcrowding, reduced hospital beds, and longer wait times for surgery. Paying people better will improve care.
Is this a stealth campaign to organize health care workers into a union?
No. This is a campaign to improve the quality of healthcare in Arizona and improve the standard of living for hospital workers. There is no effort under way to organize healthcare workers in Arizona.
What is surprise billing, and why do we need a law to ban it?
Just about everyone has experienced it themselves, or knows someone who, through no fault of their own, got a surprise bill. Maybe during surgery the anesthesiologist turned out to be out of network, or maybe blood was sent to an out-of-network lab, resulting in charges of hundreds, even thousands of dollars that the patient is responsible for paying. Under our measure, your insurer would have to cover the service by a so-called “out of network” provider, up to their average contracted rate or 125% of the Medicare reimbursement rate.
Surprise bills are an especially big problem in emergencies, when a patient may be unconscious or in severe pain and the last thing on their mind is getting into a discussion about in-network and out-of-network treatment. It’s also a common problem with ambulance service. When lives are on the line, no one should have to worry about a surprise bill.
There is no other business that leaves us so in the dark about what things will cost. We know ahead of time what groceries will cost, or gasoline or going to a movie. This initiative will finally make sure that we have the same information about our health care, one of the most expensive things we regularly pay for, and officially end the predatory practice of surprise billing.