BISMARCK, N.D. – Insurance Commissioner Jon Godfread, sent a letter on July 2, 2019, to Senate leaders Mitch McConnell (R-KY) and Charles Schumer (D-NY), North Dakota Senators John Hoeven (R-ND) and Kevin Cramer (R-ND), and the rest of the U.S. Senate expressing his support for section 105 of the Lower Health Care Costs Act prohibiting surprise bills from air ambulance providers. The bill has been passed by the Senate Health, Education, Labor and Pensions (HELP) committee and includes protections for consumers with health insurance from balance billing by air ambulance providers. The Lower Health Care Costs Act is expected to be taken up by the Senate before their August recess.
“In North Dakota, we have nine air ambulance providers; some are independent, stand-alone and some are hospital affiliated providers,” Godfread said in the letter. “Most of these providers are good actors and provide a service to our consumers. The bad actors in our state use the balance billing method as a business model to prey on people during their most vulnerable time.”
State insurance regulators across the country have received a high volume of complaints from consumers who have utilized air ambulance flights and were then burdened with a surprise bill for tens of thousands of dollars, even though the consumer had health insurance. In North Dakota, from 2013 through July 2017, the North Dakota Insurance Department received 32 complaints totaling $1.77 million in uncovered charges for air ambulance services. Based upon these complaints, each air ambulance ride has cost the consumer $55,341 on average.
Godfread acknowledged in his letter that section 105 has drawn opposition from those in the air ambulance industry who have no desire to contract with health insurance companies and want to continue a business model that preys on people. These individuals and organizations have made the argument in the past that laws like the Senate HELP committee legislation will diminish air ambulance access in rural areas, a common threat made by the independent air ambulance industry when any changes are proposed. Godfread noted that North Dakota, a predominantly rural state, faced the same claims in 2015 and 2017 when similar consumer protection laws were debated by North Dakota’s Legislative Assembly. Upon passage of those laws in 2015 and again in 2017, no air ambulance providers left the state.
“North Dakota has enacted laws and regulations that have attempted to provide transparency and protection to our consumers from large, surprise bills,” Godfread said. “One law has been struck down in federal court, another is currently tied up in litigation before the 8th Circuit Court of Appeals. Despite the challenges we have faced and continue to face, we nonetheless believe we have found a prudent, fair and equitable way to resolve the crisis consumers are facing at the hands of a few bad actors in the air ambulance industry. We are, however, at a point where the only other solution outside of being tied up in lawsuits for years is action by Congress. It is not the government’s job to keep bad business models in business. It’s the government’s job to protect consumers from these very situations where they are being taken advantage of by these operators. This is precisely what section 105 of the Lower Health Care Costs Act does for our consumers.”
The letter can be read in its entirety at www.nd.gov/ndins/commissioner-communications.