H.R. 10788, Surprise Billing Deregulation. Quorum's AI analysis reads it as a net cost — and names who bears it.
H.R. 10788 · Net cost
What it does
This bill delays and weakens surprise medical billing protections by suspending the independent dispute resolution (IDR) process—which currently allows patients and insurers to challenge out-of-network charges—through the end of 2027, and then replaces it with a narrower calculation method starting in 2028 that ties out-of-network rates to 2019 contracted rates adjusted only for inflation. The bill also bars courts from reviewing the government's methodology for setting these rates, eliminating judicial oversight. The net effect is that patients face higher out-of-network bills and lose access to neutral arbitration to challenge them.
The analysis names health insurance issuers and group health plan sponsors (lower out-of-network payment obligations) — and 1 more group — among the beneficiaries.
The cost
The 2019 baseline for rate calculation is now 5+ years old; using only CPI adjustment means out-of-network rates will lag actual market costs, forcing patients to absorb the gap.
The analysis put a high warning level on this bill. Transparency scores 25%, and the analysis found no provisions unrelated to the bill's subject.
Who is behind it
Filed by Frank Pallone.
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