ST. PAUL — In recent weeks, Minnesota television viewers have been blitzed with ads urging them to tell U.S. Sen. Tina Smith to oppose “government rate setting” for payments to doctors and hospitals.
The group behind the ads, Doctor Patient Unity, spent more than $28 million to air them in states where senators are running for re-election next year, including $2 million targeting Smith, the New York Times reported last week.
The sources of that money were a mystery. Doctor Patient Unity is a so-called “dark money” political action group that doesn’t list its members or disclose its donors.
But last Friday, the Times proclaimed “Mystery Solved.” It reported that two physician staffing companies, TeamHealth and Envision Healthcare, which generate large amounts of “surprise medical bills,” were the main funders for the ad campaign.
In an interview Thursday, Smith said the ads were intended to derail legislation that would bar doctors and hospitals from charging patients for “out-of-network” medical services, usually emergency care, that is not covered by insurance. Smith is a co-sponsor of legislation to roll back surprise medical bills. It has bipartisan support and President Donald Trump has called on Congress to protect patients from surprise medical bills.
Those are unexpected bills that patients receive often for emergency care that they assumed their insurance would cover. In many cases that surprise bill is for the difference between what a doctor charged and what insurance paid, and it’s often thousands of dollars.
“I don’t think patients should pay the price when, through no fault of their own, (they incur bills) that they had no idea about ahead of time,” Smith said.
The ads don’t mention surprise bills. Instead they warn that “government rate setting” that could harm patient care.
In one ad, a man who says he represents “big insurance” steps into a hospital waiting room and tells patients to leave because “we’re closing this hospital.” Asked why, he answers that “insurance companies teamed up with Congress” to set rates that will mean “doctor shortages and hospital closures.” It then asks viewers to call Smith and ask her to “protect patients.”
Smith: Many left confused
The ads “did not prompt significant reaction from people,” the Minnesota Democrat said. “We heard a lot about it at the State Fair. Mostly people were kind of confused about what was happening, what it was all about.”
To Smith, the ads were “flat-out misleading.” The bill she backs would stop surprise medical billing of patients and require health-care providers and insurance companies to use arbitration to resolve billing disputes. On its website, Doctor Patient Unity supports that approach.
Another bill in Congress, which Smith opposes, would set federal rates to settle billing disputes.
In a statement to the Times, Doctor Patient Unity spokesman Greg Blair said, “We oppose insurance-industry-backed proposals for government rate-setting that will lead to doctor shortages, hospital closures and loss of access to medical care, particularly in rural and underserved communities.”
Smith thinks the group targeted her because they oppose any limits on their billing practices.
“The ads were designed to intimidate me, and I’m not going to be intimidated,” she said.
How it’s done in Minnesota
The ads may have fallen flat in Minnesota because surprise bills are a smaller problem here than in other states.
A report from the nonpartisan Kaiser Family Foundation in June found that roughly one in every six Americans taken to an emergency room or checked into a hospital receives a surprise bill following treatment. But in Minnesota only 2% to 3% of patients receive such bills.
That may be in part because the 2017 Legislature passed a law limiting how much a patient can be billed for services that are not covered by insurance.