Senate Republicans continue push for low, transparent pricing in health care

Senate Republicans promoted several key pieces of legislation today that focus on making prices for common health care services clear and transparent to the average consumer, avoiding hidden costs, and saving people money on prescription drugs. The proposals are the latest step in Senate Republicans’ continued effort to lower Minnesotans’ health care costs.

The proposed legislation includes:

  • F. 3033 (Jensen) – Requires health care providers to post transparent prices for their twenty-five most commonly billed services and procedures in the reception area of the clinic and on their website.
  • F. 3480 (Draheim) – Requires health care providers and health insurance plans to provide a good faith estimate of the total health care costs a patient will be required to pay for a visit.
  • F. 2746 (Draheim) – Requires health care providers to disclose hidden facility fees a patient might be required to pay for services or procedures.
  • F. 2836 (Jensen) – Saves consumers money on prescription drugs by allowing pharmacists to inform consumers when the cash cost of a prescription is less than the insured cost.

Two of the proposals require health care providers and health insurance plans to provide clear cost estimates to consumers. S.F. 3480 allows consumers to request a good faith estimate for expected services, which health care providers and health insurance plans are required to provide within ten days. S.F. 3033 requires health care providers to publicly post pricing for their most commonly billed evaluation, management, and preventative services. The price list must include the provider’s cash pay rate, the insurance reimbursement rate, the Medicare rate, and the Medical Assistance rate for each item.

“Free market principles drive down costs. Yet, in health care, we restrict the ability of providers and patients to participate in a free market,” said Senator Scott Jensen (R-Chaska). “If we lift the veil on health care pricing and allow patients to not only ‘shop around,’ but have free and open conversations with their pharmacists and physicians, the cost curve will be bent downward.”

“In this age of internet commerce, we are accustomed to quickly comparing prices for nearly any product or service we wish,” said Senator Rich Draheim (R-Madison Lake). “I see no reason why health care should be any different. Just like you would receive an estimate from an auto mechanic, patients should know how much a medical procedure will cost them prior to committing to it.”

Another Republican proposal puts an end to hidden “facility fees” that patients are often unaware of when they receive services. For example, two competing clinics may charge similar rates for a procedure, but if one also charges a facility fee, then the out-of-pocket cost of the procedure may be significantly higher at that clinic. S.F. 2746 guarantees patients understand what they’re being charged by requiring disclosure of facility fees up-front.

The last bill lowers the out-of-pocket cost of prescription drugs for consumers by lifting the pharmacy gag rule. The gag rule is a common clause in pharmacy contracts that prevent pharmacists from telling consumers when a drug could be purchased cheaper with cash instead of billing through insurance. Under S.F. 2836, consumers will save money by allowing pharmacists to provide the best possible price for a prescription.

Republican-backed reforms passed last year were successful in stabilizing Minnesota’s individual health insurance market and lowering the cost of insurance premiums below the national average, while other states saw significant premium increases.