Policy Matters

One in three Americans has a hard time paying medical bills

2012-03-09T12:51:00.002-07:00

A new survey shows difficulty paying medical bills is widespread across the nation. During the first half of 2011, one in three people lived in a family that had trouble paying medical bills during the previous year, were paying a medical bill over time or had a medical bill that they were not able to pay at all, the National Center for Health Statistics found.

The survey demonstrates people with incomes just more than the federal poverty level were the most likely to struggle with medical bills. Among respondents in that "near-poor" category, 45.8 percent had difficulty paying for medical care. Coverage of the survey is available from NPR.

Senate Bill 12-134, the Hospital Payment Assistance Act, addresses the issue and helps working families who cannot afford insurance to responsibly pay their hospital bills. The bill is awaiting a final vote by the Colorado Senate, after which it will begin hearings in the House. Follow developments with the bill between editions of Health Law and Policy Update at CCLP's Hospital Payment Assistance Program action center.

Amended Hospital Payment Assistance Act passes unanimously out of committee

2012-02-27T10:52:00.000-07:00

An amended version of Senate Bill 12-134, the Hospital Payment Assistance Act, passed unanimously out of the Senate Health and Human Services Committee on Thursday. The measure, sponsored by Sen. Irene Aguilar and actively supported by the Colorado Center on Law and Policy, gives working families important information about hospital discount policies and charity care, and a chance to responsibly pay their medical bills. Details are in a revised fact sheet. The Colorado Hospital Association (CHA) announced support of the bill in a statement released Thursday.

"As presented today by Sen. Aguilar, the proposed amendments to Senate Bill 134 recognize that hospitals should be permitted to maintain charity care policies that reflect the unique needs of the communities they serve and the financial realities of health care reform. As previously stated, CHA and its members believe the bill language governing hospital charity care policies should directly align with current and expected federal requirements. Sen. Aguilar has shown exemplary leadership in working with CHA to address and mitigate related concerns," the statement said.

The bill as amended, increases transparency about hospital charity care and discount policies, offers patients with incomes of less than 250 percent of the federal poverty level a discount on hospital bills equivalent to the lowest negotiated rate paid by a private insurance company, and requires hospitals to offer people reasonable payment plans before initiating collections actions.

The bill will be heard in the Senate Appropriations Committee on March 2. The bill as introduced had a fiscal impact, but that impact is expected to have been eliminated by the amendment adopted Thursday. Following the Senate Appropriations Committee hearing, the bill will move to the Senate floor.
Follow developments with the bill between editions of Health Law and Policy Update at CCLP's Hospital Payment Assistance Program action center.

It's a big day for the Hospital Payment Assistance Program

2012-02-23T09:02:00.002-07:00

The Senate Health and Human Services Committee is expected to vote today on Senate Bill 12-134 to create the Hospital Payment Assistance Program. Find details in an action alert CCLP sent yesterday.

Committee delays action on Hospital Payment Assistance Act while parties negotiate

2012-02-17T15:44:00.003-07:00

A legislative committee heard details about the proposed Hospital Payment Assistance Act on Thursday but delayed a vote on the measure, pending amendments on the bill. Sen. Irene Aguilar, the sponsor of Senate Bill 12-134, expressed a desire to continue working on a compromise.

The Colorado Center on Law and Policy is backing the bill along with the Colorado Consumer Health Initiative. CCLP is optimistic continued dialogue with Colorado hospitals will lead to a solution that, as Aguilar described it, will allow uninsured patients "the dignity to pay their bills without going bankrupt."

Thursday's hearing before the Senate Health and Human Services Committee was the first public hearing for Senate Bill 12-134. The measure gives uninsured patients the opportunity to understand and responsibly pay their hospital bills without fear of being sent to collections or going into bankruptcy. Patients who have been subject to high levels of medical debt, a bankruptcy attorney and hospital executives were among those offering testimony to the committee.

CCLP and the Colorado Consumer Health Initiative offered testimony on the lack of transparency regarding hospital prices and charity care policies. Hospital sticker prices are significantly higher than the actual amount paid by private insurers or Medicare, which leaves only the uninsured paying the full price for hospital care. The consequences for consumers can include being sent to collections, paying additional fees and ultimately bankruptcy.

A number of uninsured patients testified to the difficulty they had understanding their hospital bills. Many of the patients were never informed of or were unable to find information about hospital discount or charity care policies. Nick Wimmershoff, a local bankruptcy attorney, said he sees cases where medical debt leads to bankruptcy, but that's not necessarily the end of the problem. Even after discharging debt in a bankruptcy, patients often have ongoing need for medical care, which can result in additional unmanageable debt.

The testimony included several stories about patients who refused treatment because they were uninsured and did not want to incur the financial burden of a hospital stay. One story detailed how a pregnant woman refused a pelvic ultrasound to determine if she had an ectopic pregnancy, due to cost of the procedure. She ended up in the emergency room a few days later with a rupture and potential shock, necessitating a much more serious extensive surgery and a prolonged hospital stay.

Among the concerns expressed by the Colorado Hospital Association and two hospital executives was that requiring hospitals to charge uninsured patients no more than the cost of providing care would harm rural hospitals. Responding to the point, Aguilar shared data demonstrating that certified critical access hospitals in Colorado already charge much closer to cost than many of their urban counterparts. Therefore, rural hospitals would not need to significantly change business practices to comply with the new legislation, she said.

Find news coverage from The Denver Post and the Denver Business Journal.

For more information about the bill, and for ways you can get involved, visit CCLP's Hospital Payment Assistance Program action center.

Sides try to sort out differences over Hospital Payment Assistance Program

2012-02-17T08:22:00.000-07:00

Yesterday's hearing in the Senate Health and Human Services Committee was the first public exploration of policies that could help uninsured and underinsured Coloradans responsibly pay their hospital bills. A committee vote on Senate Bill 12-134 was delayed while consumer advocates negotiate with hospitals over possible changes to the bill, the Denver Post reported. The Denver Business Journal also covered the hearing.

Stay tuned for more in today's edition of Health Law and Policy Update, and keep an eye on our Hospital Payment Assistance Program action center for the latest information.

Hospital Payment Assistance Program hearing set for Feb. 16

2012-02-10T11:15:00.000-07:00

Senate Health and Human Services Committee members next week will consider a bill to establish a Hospital Payment Assistance Program, a measure advanced by the Colorado Center on Law and Policy and other advocates for health care consumers.

The hearing on Senate Bill 12-134 is scheduled for 1:30 p.m. Thursday, Feb. 16, in Room 356 of the State Capitol. The bill would help people pay their hospital bills by making it easier to get information about hospital charity care and discount plans, limiting the amount uninsured people can be asked to pay on a hospital bill and establishing standards that must be met before a hospital can send someone who is uninsured to collections. Find more detail in a fact sheet prepared by CCLP and the Colorado Consumer Health Initiative.

People who favor the bill can support its passage in a number of ways:

Attend the hearing. Committee hearings are open to the public and a great way to connect with other supporters.
Tell your story. If you or someone you know is uninsured and has had difficulty paying hospital bills, contact CCLP Communications Director Perry Swanson by e-mail or at 303-573-5669, ext. 306. Personal stories are one of the most persuasive ways to emphasize to lawmakers that Senate Bill 12-134 would be helpful to their constituents. You don't have to be an expert; just consider sharing your own experience.
Keep informed and be ready to act. As the bill works through the legislative process, CCLP will post frequent updates to a new page on our Policy Matters blog. Visit the page to find more resources and ways to get involved.