Many Americans may not realize that a U.S. law is creating billions in additional healthcare fees, driving up prices for all patients who simply seek cures to their ailments.

The No Surprises Act, passed in 2020 to protect consumers from ‘unexpected and unavoidable’ out-of-network bills, settles disputes between providers and insurers about out-of-network claims. The downside is that its arbitration process is generating billions of dollars in extra costs for healthcare systems. Many worry that these costs could later impact patients with higher consumer premiums.

Under the Act, if both the providers and insurers cannot come to an agreement on bill negotiation, “both sides file what they believe a fair price would be for that medical service and a third-party arbiter certified by the government picks between the two offers.” 

While this process does shield patients from unexpected bills, it also drives up administrative spending costs. Ever since the No Surprises Act went into effect in 2022, it has created an estimated $5 billion in costs. This is due to the high number of claims, high provider participation and high offer amounts.  

The good news is that policy makers are being urged to address the high volume of ineligible disputes that clog up the process. In fact, many lawsuits have been filed over the years regarding the large volume of disputes, specifically those backed by private equity firms.

Solidarity HealthShare has been committed to price transparency from the very start. We believe that patients should be protected from outrageous medical bills and will fight for fair coverage at every step of our Members’ health journey. To that end, we’ve negotiated directly with providers to ensure delivery of high-quality and affordable, life-affirming healthcare for the more than 46,000 Members we have served since 2016. 

To learn more about how you can sign up for a Solidarity membership, give us a call at 737-SHARING today.