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Patients should never have to decide between ‘life or debt.’ The “No Surprises Act” has been introduced to protect Idaho citizens from receiving notifications of surprise bills (a practice also known as balance billing). However, this hot button issue has been falsely titled from the start. This is not about surprise bills; it is a surprise lack of coverage!

As insurance networks continue to narrow, the possibility of receiving surprise medical bills becomes more likely, especially when a patient suffers an emergency. Instead of covering necessary and life-saving care for their customer, they pass along the uncovered bill to their patient.

The proposed bill (HB387) doesn’t work for emergent care. Critically ill patients don’t get a chance to compare rates or sign agreements about the services to be rendered. You might be unconscious, and medical decisions have to be made for you. Under EMTALA, it is illegal for a physician to even ask about your insurance coverage before rendering care.

As an emergency physician, I am obligated to treat every person that arrives in my department regardless of their insurance coverage or lack thereof. This is why we comprise the safety net for the 1.75 million residents of our great state. Insurance companies are wise to this. They understand that we must provide care, and as such many companies refuse to negotiate fair market rates with independent physicians like myself.

We have consistently asked the health and welfare committee to consider compromise including fair market value payments or adding an independent dispute resolution (IDR) provision. Both of these solutions would keep patients out of the middle, which is the goal of local physicians and legislators, alike! The IDR process has been incredibly successful in other states and a federal bill introduced by Rep. Ruiz (H.R. 3502) seeks to replicate this process.

I urge readers to take a pause. Call your representatives and ask them to oppose house bill 387. Please consider the downstream implications. If this bill passes many doctors will no longer take call for emergencies. Independent practices will shut down and move out of state. Rural communities will have difficulty recruiting practices to their communities. Idaho already have a physician shortage, this will only complicate matters further.

The health and welfare committee has forgotten that physicians have taken an oath to protect our patients; their physical and fiscal health are our priorities. Give physicians a chance to sit at the table with you. We understand health care, and we can work with you to develop a better plan.

Jonathan Miller, M.D., is a board certified emergency medicine physician living and working in Boise. He is the vice president of the Idaho chapter of the American College of Emergency Physicians.

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