Thank you, Chair Greenlick and members of the committee, for the
opportunity to testify in support of House Bill 2213. My name is Laura
Etherton, consumer advocate with Oregon State Public Interest Research
Group (OSPIRG).
Oregonians are facing steeply rising health care costs. Consumers pay
not only skyrocketing prescription drug prices and increasing insurance
premiums, but also higher co-pays, deductibles, co-insurance, and other
forms of cost sharing. Consumers are shouldering more of the burden of
the rising cost of health care, but too often they are unable to obtain
even the most basic information about cost and quality when they are
making decisions about treatment.
House Bill 2213 takes an important step forward to increase cost
transparency by giving insured consumers the right to know the cost, or
at least an estimate of the cost, that they will bear for a specific
treatment. This disclosure is important across the board, but it is
especially critical for significant procedures where a high deductible
or co-insurance is involved. A consumer facing a 20 percent
co-insurance rate for procedure that ultimately costs $50,000 will pay
$10,000. He should be able to find out about that cost in advance for
planning purposes, and in order to be able to shop around, to the
extent possible given his health condition, for the best value.
The
bill also would require insurers to use a standard method to determine
the "usual, customary and reasonable" costs for services insurers pay
to out-of-network providers, and directs the Director of the Department
of Business Services to establish that standard method through
rulemaking. Because of the increased cost sharing, many health
consumers ultimately end up paying a considerable share of these costs.
Having a standard method to calculate these costs should be helpful,
provided it does not result in an additional cost shift to the consumer
when the out-of-network provider charges more than the “usual,
customary and reasonable” amount.
Thank
you again for the opportunity to testify in favor of House Bill 2213.
On behalf of OSPIRG, I encourage the committee to pass this bill.
