McCaskill pushes back on ER costs

Patients, hospitals across state could be at financial risk after Anthem announced it would no longer cover emergency room costs if care deemed non-emergent

U.S. Senator Claire McCaskill is pushing back on Anthem after the insurance company announced it would no longer cover emergency room costs for Missourians if the care is deemed non-emergent.

The company sent notices to its customers informing patients that “you’ll be responsible for ER costs when it’s NOT an emergency” – a change that could dramatically impact patients, who may no longer seek care in an emergency for fear it won’t be covered, and hospitals, who are obligated to provide care no matter the cost or circumstances.

“Anthem has a strong presence in Missouri, and this decision significantly impacts health care costs for thousands of Missourians,” wrote McCaskill. “…Patients are not physicians. I am concerned that Anthem is requiring its patients to act as medical professionals when they are experiencing urgent medical events. Missouri state law and federal law protects patients from having to make these types of medical decisions… Anthem’s policies are discouraging individuals from receiving needed care and treatment out of fear they may personally be fully financially responsible for the cost of treatment, even though they have insurance.”

McCaskill’s letter continues: “A direct result of this policy is a shifting of costs from the insurer to hospitals and patients. If patients are unable to pay the costs, hospitals will bear the full brunt of those costs.”

This fall, McCaskill, the top-ranking Democrat on the Homeland Security and Governmental Affairs Committee, sought answers from Envision Healthcare and its subsidiary EmCare Holdings, Inc. following reports of skyrocketing costs at emergency rooms run by EmCare. According to those reports, EmCare tripled the highest rate for ER visits at one hospital that was studied and allegedly pressured ER doctors to order expensive, unnecessary tests for patients. EmCare manages more than ten hospitals in Missouri.

McCaskill has continually worked to improve healthcare in Missouri and across the country. In response to rural hospital closures across the country, McCaskill called for an investigation into the challenges these hospitals face, trends in rural hospital closures, and recommendations for the federal government about addressing these issues. Earlier this year, McCaskill introduced legislation aiming to protect access to health insurance for Missourians on the individual insurance market, amid reports of insurers withdrawing from those markets. McCaskill also joined Republican Senator Susan Collins of Maine to pass a bill to increase competition for generic drugs and lower prescription costs.

Visit mccaskill.senate.gov/healthcare to learn more about McCaskill’s fight to improve healthcare for Missourians.